Innovations Spring 2012 in nursing & health new ideas new leadership new landscape Innovations In this issue... in nursing & health Arizona State University College of Nursing and Health Innovation Promote Sustainability Opt out of the print publication and save paper Features 2 To meet the needs and usability preferences of our audience, we encourage our readers to contact us at (602) 496-0918 or email healthmarketing@asu.edu if you prefer to receive the Innovations magazine via email. The publication is available online at http://nursingandhealth.asu.edu/newsroom/magazine/index.htm New Ideas, New Leadership, New Landscape The health education landscape is changing at Arizona State University with new leaders, organizations and innovative health initiatives that cross University boundaries. 6 Editorial Mission Our mission is to produce a publication of highquality editorial news content and creative design to communicate the educational, research, and evidence-based initiatives of the College of Nursing and Health Innovation to its key audiences. Keller 1st Nursing Regent Professor Colleen Keller honored for pioneering achievements in nursing educaton and her research work providing health solutions in the clinical environment. 8 Contact Information For address changes or subscription inquiries please contact us by calling (602) 496-0918 or emailing us at healthmarketing@asu.edu A Growing Learning Resource Center LRC keeps pace with technology advances in clinical lab education with state of the art simulation technologies and fully integrated learning management tools. Sustainability Innovations in Nursing & Health is printed on paper that is certified to FSC Standards. 15 Dean Teri Pipe, PhD, RN AHRQ Harnessing Technology to Fight Child Obesity Editor R. Terry Olbrysh, Director of Marketing 500 N. 3rd Street Phoenix, AZ 85004-0698 (602) 496-0877 healthmarketing@asu.edu Researchers pursue novel approach to fighting obesity in children by utilitizing technology to identify and assess key behaviors and attitudes contributing to obesity. Focus Articles 1 Associate Editor Juliana Murphy Campbell Dean’s Message 11 Elizabeth Reifsnider — Drawing on Clinical Practice for Research 12 “Moving People” — Goal of 3 New Senior Research Faculty 18 New Transdisciplinary Consortium Launches Health Care Leader Fellowships 19 Mayo Clinic and ASU Nursing Program — Built to Last Design Lisa Sargent International PhdD Spotlight: Luxana Reynaga 22 Sherman Scholarship: A Legacy for the Spirit of Life 24 Hartford Scholars 26 Dream, Discover, Deliver Award Winners 27 Professional Achievements, New Grants and Faculty Appointments 30 Publications and Presentations On the Cover: The College of Nursing and Health Innovation and the School of Nutrition and Health Promotion, which share resources and space in the NHI Complex at the Downtown Phoenix Campus, are key parts of the evolving ASU Health Solutions initiative designed to cross boundaries to find solutions to improve health outcomes. Website http://nursingandhealth.asu.edu The College of Nursing and Health Innovation at Arizona State University is fully accredited by the Commission on Collegiate Nursing Education (CCNE) for its baccalaureate and master’s degree nursing programs through June 2014. Its new Doctor of Nursing Practice Program recently achieved a full, five-year accreditation from CCNE through June 2016. The Arizona Board of Nursing has approved these programs. News that Matters 21 Innovations in Nursing & Health is published twice a year by the College of Nursing and Health Innovation at Arizona State University for alumni, friends of the college, national nursing and health promotion leaders, students, faculty, and the media. Innovations in nursing & health ©2012 Arizona Board of Regents. All rights reserved. The sunburst logo is a registered trademark, and the word mark is a trademark of Arizona Board of Regents. All other brands, product names, company names, trademarks, and service marks used herein are the property of their respective owners. Information in this document is for informational purposes only and is subject to change without notice. A Message from the Dean I am proud of researchers’ accomplishments in our Center for Improving Health Outcomes for Children, Teens & Families. Under the leadership of Director Bonnie Gance-Cleveland, PhD, RNC, PNP, FAAN, researchers are working on solutions to many health challenges, including: • • • • addressing childhood obesity from birth to adolescence; promoting breastfeeding to reduce the risks of obesity; influencing workforce issues, including patient safety, and collaborating with communities to decrease health disparities and establish sustainable, culturally appropriate interventions through community-based research. Examples of research initiatives below provide a report on current activity. You may visit http://nursingandhealth.asu.edu/child-teen for more details or request the new Center brochure by sending an e-mail to cctf@asu.edu for more information. GirlSmart Project With NIH/NIDA funding, the Center for AIDS Prevention Studies at the University of California, San Francisco awarded Angela Chia-Chen Chen, PhD, RN, PMHNP-BC, a grant to conduct a bilingual (Spanish/English), web-based intervention, “GirlSmart,” to promote safe-sex practices among at-risk young Latinas, the second largest ethnic group affected by the HIV/AIDS epidemic. HIV/STI prevention interventions can be highly cost effective and interventions tailored to Latina adolescents’ special cultural, linguistic, and socioeconomic needs could potentially reduce health disparities in this population. Information technology may provide new avenues to increase opportunities to deliver sensitive topics on prevention in a more confidential, sensitive, accessible, and engaging manner for youth. The research team welcomes community agencies as partners to promote safe-sex practices and to reduce HIV/STI risk among at-risk young Latinas. The COPE/Healthy Lifestyles for Teens, a NINR RO1 grant awarded to the College, is now in its third year of data collection. Former Dean Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FNAP, FAAN, is principal investigator (PI) and Center Assistant Professor Diana Jacobson PhD, RN, PNP-BC, is the site PI. The randomized controlled trial’s goal is to test the efficacy of an educational and cognitive behavior skills building intervention on healthy lifestyle beliefs, nutritional and physical activity lifestyle behaviors, self concept, anxiety and depressive symptoms, and academic outcomes of 14 to 16 year old adolescents. Cohorts of adolescents and their parents were recruited from Phoenix and Tempe high school districts respectively. The research team is preparing to collect the 6 month post intervention data in May with the final 12 month data collection scheduled for November for a third cohort. American Academy of Pediatrics and WHO guidelines for the first six months of infant life and with the addition of complementary foods for the first two years or more. Mothers receive lactation information and support while in the hospital but most often don’t have support after discharge. Early and rapid infant growth is strongly associated with early development and persistence of child obesity and linked to serious health problems later in life. These findings have led Elizabeth Reifsnider, PhD, RN, WHNP, PHCNS-BC, FAAN, to study child obesity through Dean Teri Pipe public health interventions. Parenting education on early childhood has been the focus of Reifsnider’s research, which is profiled on page 11 of this issue. Horizontal Hostility and Patient Safety The Joint Commission implemented a standard in 2009 that requires hospitals to define all forms of disruptive behavior and have a process in place for dealing with it. The concept of horizontal hostility (HH) in nursing is apparent when the workplace culture or norm enables dominant individuals to pressure those who are more vulnerable. Behaviors consistent with HH vary and range from overt behavioral manifestations such as rude or belittling comments to more covert actions like withholding pertinent information. It is imperative to understand the consequences of HH and whether it influences patient safety. Working with a local Phoenix community hospital, Barbara L. Wilson, PhD, RNC-OB, sought to determine the perceived level of HH and examine potentially adverse or unsafe behaviors that the nurses exhibited as a result of the threat of it. Using a 28-item survey tool modeled after the AACN work in peer incivility (2005), all RNs were surveyed over two months. Results from this study in a single community hospital suggest that the influence of HH in the acute care environment can have a significant impact on nurses’ behaviors with potentially tragic outcomes for their patients. End Note I encourage others in the community to become involved in the outstanding research activities of the Center for Improving Health Outcomes for Children, Teens & Families. With your help, we will find solutions to a healthier future for children. The COPE research team has been welcomed into 11 high schools and serves as an excellent example of the value of communitybased research. Eating Healthy from Birth The U.S. Surgeon General issued a report last year supporting breastfeeding that emphasizes changes needed in health care infrastructure, workplaces, and society to enable mothers to follow Teri Pipe, PhD, RN Dean, College of Nursing and Health Innovation Spring 2012 1 The health education landscape has changed at Arizona State University … New leaders, new organizations, closer collaborations, and new health-related initiatives that cut across boundaries at the University. The goal is to maximize return on enterprise resources that will produce solutions to promote good health, prevent and control disease, and to improve health outcomes for patients and their families. New Ideas New Leadership New Landscape Keith Lindor, MD Executive Vice Provost, ASU Health Solutions Seeking Solutions for Better Health Keith Lindor is the new Executive Vice Provost of Health Solutions at Arizona State University. In simpler terms, he is responsible for ASU’s strategic initiative to build a new model for integrated, interprofessional health education to improve health outcomes for our residents. His charge is to marshal the numerous health-related resources and assets across ASU, a goal as complex as it is large. Dr. Lindor joins ASU from Mayo Clinic in Rochester, Minn. where he served as Dean of the Mayo Clinic Medical School for the past seven years. At ASU, he will be responsible for developing the new School of the Science of Health Care Delivery and working with others to develop ASU’s Master’s Degree in the Science of Health Care Delivery, a version of which will be embedded in the curriculum of the recently announced Mayo Medical School in Arizona. All Mayo Medical School students will complete the specialized master’s degree granted by ASU, concurrently with their medical degree from Mayo Medical School. Included among the resources that Dr. Lindor will need to achieve the University’s goals are the School of Nutrition and Health Promotion, the Department of Biomedical 2 Innovations in Nursing & Health Informatics, the College of Nursing and Health Innovation and other related units such as the School of Biological and Health Systems Engineering and numerous research centers and programs including the Center for Health Innovation & Clinical Trials, the Center for Health Information and Research, the Center for World Health Promotion and Disease Prevention, the Health Care Delivery and Policy Program, and the Healthcare Transformation Institute. Right Time for Change “It is time for a new model of integrated health education and delivery given the current costs and patient outcomes of the U.S. health care system,” Lindor said. “America spends twice as much as the next nine most expensive countries for health care yet we are ranked 37th for health outcomes according to the World Health Organization. We need to move to a longitudinal model for health solutions since health promotion and care are delivered at many other venues than just hospitals today.” Lindor believes Arizona is a good state and ASU a great university at which to build that model. The state has a highly diverse population which is underserved, lacks access to health care, and is at higher risk for chronic illnesses such as obesity and diabetes. “ASU does not have its own medical school or center which often have interests in the status quo.” Experience Best Teacher The former medical school dean cites his experience there in developing and implementing a new curriculum as preparing him for his task at ASU. “My team worked as quickly as possible to develop the curriculum to improve the students’ educational experiences,” Lindor said. “We were surprised by faculty, staff and student reaction to the new curriculum when it was announced. It taught me to bring people into the process earlier to ask questions and suggest ideas. The final result of the effort was outstanding as the Liaison Committee for Medical Education issued no citations on its last visit.” The experience helped to refine the management style that Keith Lindor brings to his task at ASU. “I try to take the time to make sure that everyone understands what we are trying to do and let them ask questions or tweak the plan,” the new executive vice provost said. “This approach makes for a better and less painful implementation. That is especially important here when so many of the resources on which this initiative relies do not reside under one roof.” Measurement is another key part of Keith Teri Pipe Dean, College of Nursing and Health Innovation Ready for Challenges of New Post Lindor’s leadership style. “Measuring results is important but measuring what matters most is more important,” Lindor noted. “You have to measure the right factors that can be measured accurately; respond to those results, yet not let the measurements run you.” First Year Focus Keith Lindor is focused on forming the ASU School of the Science of Health Care Delivery and its curriculum during his first year on the job. He expects the degree program to launch in fall 2013, one to two years before the Mayo Medical School Arizona is expected to open. His time is currently consumed in talking with many colleagues in other disciplines at ASU to determine the building blocks of the MS in Health Care Delivery curriculum, as well as to develop the strategy to help the University achieve its goals of improving health outcomes. Personal Passion Applies Gardening has been a personal passion for Keith Lindor and his wife Laney for many years. Keith said he loves to come up with the right concept to create a beautiful garden and landscape – visualizing which shrubs and plants should be used and how they should be placed to create the right effect. He will certainly have ample opportunity to apply those skills and experiences from his avocation as he conceptualizes and grows an integrated model of interprofessional health education at ASU.  We never know where life’s twists and turns will take us in our careers. That is certainly the case with Teri Pipe, PhD, RN, who was very satisfied in her position of more than 10 years at Mayo Clinic in Arizona as director of Nursing Research and Innovation. Then one day in May 2011, a call came from Arizona State University asking if she would be interested in serving as interim dean of the College of Nursing and Health Innovation since Dean Bernadette Melnyk had accepted a position at Ohio State. After a national search, she became Dean Teri Pipe, a title that she had not thought of seeking only eight months earlier. Teri Pipe was well acquainted and prepared for the responsibilities in nursing education and administration. At Mayo Clinic, she served as an associate professor of nursing in the College of Medicine, at ASU as an adjunct nursing faculty for 10 years, and at Grand Canyon University as an assistant professor of nursing for two years. Her career experience also includes work as a case manager and supervisor for a private clinic in Illinois, a prenatal nurse care manager for a family planning clinic, a CNS trainee on an interdisciplinary team in geriatrics, a charge nurse, and a volunteer hospice nurse. Teri Pipe became interested in promoting health and well-being at age 13 when she started volunteering at a Billings, Montana hospital. She saw and learned the “24 x 7” impact of nurses with patients and families. That inspired her and she continued looking for opportunities to learn and apply knowledge to empower individuals to improve their own health, which led to her career choice of nursing. Pipe’s nursing education took her across the nation from her native Montana. She earned a PhD in Health Policy and Administration from Penn State, a MS in Nursing with a focus on Gerontology from the University of Arizona, and a BSN from the University of Iowa. Clinical Experience Formed Research Interest Dean Pipe’s research interests grew out of clinical practice. For many years, she worked with older adults or those living with a diagnosis of cancer. “The elderly and cancer patients taught me the value of living life fully,” she explained. “Some individuals seemed to manage the challenges more effectively than others so I began investigating the concept of resilience in patients and caregivers. One intervention that I have focused on in my research is mindfulness, or paying attention intentionally to the present moment. This approach has implications for how present a nurse is with a patient, which can impact how well they understand the patient’s situation and Spring 2012 3 dream • discover • deliver are able to detect changes in the patient’s condition and advocate for that patient.” Leadership Preparation at Mayo Dean Pipe credits her experience at Mayo Clinic with preparing her to lead in a large organization to achieve results. She witnessed and participated in leveraging Mayo’s guiding mission to energize a workforce to create desired outcomes and deliverables. “I collaborated extensively with interdisciplinary teams to lead change, which is a skill set that is directly transferrable to the role I play now,” Dr. Pipe said. “Mayo Clinic has an insatiable appetite to continue to do things better, regardless of how positive the status quo is. I see that same kind of dedication to constant improvement at ASU, with the additional energy toward innovation that pushes the edge of newness. That is part of what drew me to ASU.” Goals for Year One In her first year, the dean plans to build on the strong foundation and trajectory of education, research and practice that has been established in the College, with an expansive, transdisciplinary approach that capitalizes on what nursing has to offer and embraces opportunities to work with other disciplines. “I am very interested in preparing graduates who are well equipped to be flexible, innovative leaders,” Dean Pipe stated. “We need people who can think and behave differently and much more creatively to address the health needs of this country. Interdisciplinary education is vitally important as we seek solutions for the complex issues facing the U.S. health care system. Graduates should be able to elevate the dialog about health care to focus on solutions that bring value, safety and quality to the patient, family and community.” Challenges on the Horizon Teri Pipe looks forward to the 4 College playing an important role in the new Health Solutions initiative at ASU to align health-related programs across the University to provide solutions for a major recognized problem. “Our focus on innovative, transdisciplinary approaches to health promotion, disease prevention, and management of health across the lifespan position us very well to collaborate with others across the university and in the community on health solutions,” she noted. Another challenge Pipe takes very seriously is to not only sustain the impressive progress the College has made over its life, but also to launch the outputs of the skills, ideas and talents of students, faculty, staff and alumni to have more impact. The recently appointed dean also is helping to lead the curriculum development for the new MS in the Science of Health Care Delivery. An area of improvement that the new dean has targeted is to capitalize on and leverage the College’s strengths by building stronger connections with educators, researchers and innovators within ASU. Quiet Leadership Evelyn Cesarotti, PhD, FNP-BC, FAANP, associate dean of nursing academic affairs, believes the College has been fortunate to have had “the right dean for the right time.” Dean Pipe, with her background in health policy administration and experience in the Mayo health care delivery system, brings knowledge and skills needed as we enter a new era of expansion and collaboration with the recently formed Health Solutions organization,” she said. Dean Teri Pipe describes her leadership style as one of “quiet strength that listens, observes and responds to the emerging situation, guided by a vision of a more optimal future.” That style will serve her well as she guides the College of Nursing and Health Innovation into the world of more collaborative health care.  Innovations in Nursing & Health Linda Vaughan Director, School of Nutrition and Health Promotion Taking Nutrition and Health Promotion to a New Level Linda Vaughan, PhD, RD, FADA, has dedicated her entire career to Arizona State University except for two years as a nutritionist in a WIC clinic in the Phoenix area and two years as a faculty member at the University of Nebraska. It has been a successful three plus decades as she rose in rank to a tenured professor and chaired the Nutrition Department. But she regards a recent organizational milestone as the highlight of her career. As part of seven various schools and colleges since its inception in 1909, the Arizona Board of Regents in May 2011 approved the establishment of the School of Nutrition and Health Promotion (SNHP) at the ASU Downtown Phoenix Campus with Linda Vaughan as director. Vaughan’s dream of a home for her discipline and other health promotion programs to come together to have the maximum impact on the public’s health has come true. Sustainability of School “The establishment of the school reflects the emphasis President Michael Crow and Provost Betty Capaldi are putting on Health Solutions as a key initiative at ASU,” Professor Vaughan said. “In addition, our establishment elevates the importance of health promotion efforts, focusing on behavioral change and lifestyle interventions, as key to improving the health of our community, state and nation. The treatment of disease is significantly more expensive than the prevention of disease through lifestyle interventions, including nutrition, physical activity, and mindfulness.” At the new interdisciplinary school, the 3,200 SNHP students study and learn together, gaining an appreciation of the scope and teamwork needed for health promotion to impact public health outcomes, the director noted. As a part of the evolving Health Solutions initiative at ASU, School faculty will have a major role to play in the development of the curriculum for the new MS in the Science of Health Care Delivery, particularly in the behavioral change and health promotion areas. In addition, they will collaborate with scholars across ASU to contribute to the Arizona Obesity Initiative, a multidisciplinary effort to reverse the global epidemic of obesity, particularly among children and minority populations. School faculty already are collaborating with faculty in the College of Nursing and Health Innovation, School of Life Sciences, Biomedical Engineering Program, Physical Education Program in the Mary Lou Fulton Teachers College, School of Sustainability, and the Doctor of Behavioral Health program, among others. Challenges Facing School Annual enrollment increases of 10-20 percent in most degree programs present challenges for faculty to ensure that all students receive a rigorous education that prepares them for health professions and practices of the future. The School of Nutrition and Health Promotion also is challenged by the need to increase the breadth and depth of scholarship among faculty and graduate students. Carol Johnston, PhD, RD, who succeeded Linda Vaughan as director of the Nutrition program, credits her with building it from a modest program of 80 students in the 1990s to a nationally recognized program today that is the second largest nutrition program in the nation with an enrollment of 800 students. “Linda’s organizational, technical and intrapersonal skills were key to these successes,” Johnston said. “Her expanded leadership role helps position ASU as a leader in healthy lifestyles programs and useinspired research.” Vaughan’s primary goal during her first year as director is to hire and retain the highest caliber faculty and staff in order to best serve students and the community. “We continue to develop new academic programs that satisfy emerging academic and professional needs and revise existing curricula to sustain relevancy,” she added. Vaughan also has committed to retaining the nationally accredited status of the dietetics programs, attaining full accreditation for the Medical Laboratory Science program, and achieving accreditation status as appropriate for newly developed programs. Stepping up Research and Scholarship When ASU completes the build-out of more than 8,000 square feet of new research facilities for the School, faculty, staff and students will have the necessary space and equipment to compete more effectively for federal, foundation, and corporate funding. Health Solutions provides excellent staff support to faculty seeking and securing external funding through the Office of Research and Scholarship. Its support already has enhanced faculty productivity by providing infrastructure services in identifying opportunities and supporting the grant application and post-award processes. Current and future faculty with research obligations clearly understand the expectations of the School and ASU, Dr. Vaughan stated. Success for tenured and tenure-track faculty is defined in large part by research/ scholarship efforts. Productive faculty are eligible for reduced instructional obligations in order to continue or expand their successes in attaining external funding. The Leader You Need Barbara Ainsworth, PhD, MPH, FACSM, Exercise and Wellness professor, describes Linda Vaughan’s leadership style as inclusive and always representing the best interests of the faculty and students. “Under her leadership, the School has integrated the Kinesiology Program, developed the Health Sciences undergraduate major, strengthened the EXW Program by doubling its tenure track faculty, and obtained needed resources to support a near tripling of our undergraduate student enrollment.” In conclusion, Linda Vaughan is the type of leader that ASU nutrition and health promotion programs has always needed. Now she has the unified academic organization that can make a difference in preparing students to help people lead healthier lives.  David W. Coon Associate Vice Provost of Research Health Solutions Health Research Bridges Boundaries at ASU R esearch has taken on several dimensions in the new health landscape at ASU. The core role of increasing extramural funding has not changed but a new dimension has been added that is designed to extend and expand ASU’s efforts to find better health solutions. As associate vice provost of Research, Health Solutions, David Coon’s responsibilities cut across three levels. First, he is responsible for providing infrastructure support for faculty researchers in the College of Nursing and Health Innovation and the School of Nutrition and Health Promotion through the Office of Research and Scholarship and the Data Lab, as well as centers for clinical trials and world health and disease prevention. Dr. Coon views these relationships as linkages with research counterparts and colleagues rather than hierarchical. At the Health Solutions level, Coon acts as a bridge or connector to other health-related parts of ASU and strategic partners such as Mayo Clinic. His goal is to foster collaboration for research across those units to produce a sum of results larger than the individual parts could produce alone. In that role, he seeks to identify opportunities and bring back information (i.e., data) of use to the academic and research units his group supports. Finally, David Coon remains actively engaged in his own research. His recent grants with community partners have brought research funding of more than $3 million into ASU and the state. One focus of his research has been to help dementia patients and their caregivers to transform and sustain behavioral change that provides better health solutions for both. “I am fortunate that my research expertise is in line with ASU’s initiative to increase the interprofessional health education and research to provide better health solutions for residents of Arizona and America,” Dr. Coon said. “It is what has been my passion throughout my career.”  Spring 2012 5 Colleen Keller dream • discover • deliver First ASU Regents Professor from Nursing C olleen Keller, PhD, RN-C, FNP, FAHA, FNAP, APRN, FAAN, has been honored for her many career accomplishments as a nursing educator and researcher. Among other honors, she has been elected as a Fellow to the prestigious American Academy of Nursing and the National Academies of Practice. Her most recent honor of being named the first ASU Regents Professor from the ASU College of Nursing and Health Innovation is perhaps the most satisfying since it is at her alma mater. The first foundation professor in Women’s Health (2008) and director of both the Hartford Center of Geriatric Nursing Excellence and the Center for Healthy Outcomes in Aging, Keller is among the leaders who research geriatric and racial disparities linked to specific health outcomes, such as cardiovascular health, based on evidence obtained in her clinical practice. She is an expert clinician and nationally recognized scholar who is among the few researchers whose work is being translated into the clinical setting to improve health outcomes. Keller is one of the first researchers in the nation to research health promotion among minority women. She identified the need to develop culturally appropriate interventions that are contextually based and devised a social support model that has been used in community interventions across the U.S. She currently is the principal investigator and coinvestigator on two NIH R01 studies. 6 Innovations in Nursing & Health In reflecting on her career, Professor Keller said becoming a nurse practitioner (NP) after 18 years as a critical care nurse has been significant to her research. “It enabled me to ‘marry’ clinical practice with my research,” she said. “I moonlighted at community health clinics for 15 years after I was certified as a NP and currently work one day each week at Maricopa Integrated Health System Women’s Health Center.” The patients she serves at the Maricopa Integrated Health System Women’s Health Center are primarily younger Hispanic mothers to whom she provides family care, family planning, and prenatal care. The new Regents Professor feels the practice links to her research since Hispanic mothers are not as likely to focus on their own health after their first baby. “My practice is closely linked to a primary goal of my research to strengthen ethnic and racially diverse women’s decision-making about their own health,” the ASU professor of nursing said. “Minority women with health disparities that put them at greater risk for metabolic disease and who lack access to health care have an inner core strength that they need to be helped to recognize.” A BSN graduate of ASU, Colleen Keller is on her second tour of duty at her alma mater. She first served on the ASU nursing faculty from 1988 to 1994 before joining the School of Nursing at the University of Texas Health Science Center at San Antonio. “I returned to ASU because the university recognizes nursing as a science and has earned a transdisciplinary reputation nationally,” Dr. Keller explained. “I also was attracted to work with former Dean Bernadette Melnyk who made the college a trendsetter and who understood that our science goes beyond diagnosis. Now our challenge is to make the products of our research sustainable.”  “Geriatrics isn’t an age. It is a process in the care and research that we provide that has to cover the lifespan.” Colleen Keller Spring 2012 7 Growing a Learning R T he Learning Resource Center (LRC) is a distinctive, vibrant source for student centered active learning. Graduated nurses tell us, “I wish I had this when I was in school.” Even recent graduates would not recognize how changed the LRC is today. Technology, changes in evidence-based patient care practices, more complex skills required to deliver instruction, and organizational consolidation at ASU have had a major impact on the clinical lab education landscape in the LRC. And as different as it is compared to even two years ago, the LRC anticipates even more changes to come. Continuous Growth In fall 2006, the LRC tripled its space to 12,000 square feet with one simulation suite when it moved to the ASU Downtown Phoenix campus (DPC) from the Tempe campus. The consolidation of Polytechnic and West campus nursing programs downtown in 2010-2011 required further expansion to 16,000 square feet that includes 8 simulation rooms, 5 debriefing rooms, 3 control rooms, 24 clinical labs, and 10 simulation beds. Use of the facilities has increased to more than 1,500 hours in clinical practice labs and 1,000 simulation hours at the DPC and Mayo campuses every semester. Each student has over 40 hours of simulation during their last two years of the undergraduate Bachelor’s of Science in Nursing (BSN) program spread throughout each semester. Changes in the Staff Skills The skill levels required to deliver high-quality clinical education also have changed markedly in the LRC during the past six years. To meet the increased need for expertise, the volume of students, and the other varied research and pilot projects occurring in the LRC, the job descriptions and training requirements for the nursing staff support has evolved to the Simulation Nurse Specialist (SNS) from the former Lab Coordinator role. It now takes up to six months to fully learn this role and to manage the various technologies used in the clinical labs and simulations. SNSs have or are completing their Master's in Nursing Education degree and are well versed in interactive education strategies. Even though simulations are scripted based on the objectives and student class level, it’s a delicate balance of faculty and simulation specialist working together to cue students based on their responses and provide an authentic practice environment. Partnering 8 Innovations in Nursing & Health with faculty to provide a positive learning environment is the key to students’ success in gaining valuable insight into their own practice. The Pace of Technology Change The pace of technology change in the LRC is astounding. For example, the College of Nursing and Health Innovation Simulation and Technology, a Blackboard-based system, organizes and provides materials related to simulation and other technologies for students and faculty. Components include: • A learning module orienting students and faculty to the simulation environment and the manikins, • Information for students introducing them to the simulation patients and their personalities, • Videos reviewing management of IV and feeding pumps used in simulation scenarios. Simulation templates for faculty provide direction for simulation events and guide reflection. Additionally, there are “Simulation in Nursing” videos for faculty produced on-site by Cengage Learning, an educational media company. The videos serve as refreshers for faculty and a resource for new faculty orientation to simulation. METI Learning Space® (MLS) is a fully integrated learning management product that allows simulation to be captured and stored on a server, with performance assessment tools and feedback. The MLS system capabilities include: • Students can self schedule for an upcoming event, • Faculty can flag comments regarding behaviors at a specific point in the simulation video, • Scored competency assessment tools are affiliated with stored video, • Students self evaluate when automatic e-mails are sent after their simulation experience with a link for not only viewing the video but also receiving faculty evaluations and specific comments, • Faculty can view simulations synchronously or asynchronously from a distant location for discussions related to the simulation. The LRC also has used MLS for recording interviews of nutrition and exercise and wellness students for a Healthy Lifestyle g Resource Center A Time of Growth and Change in the LRC Coaching course. In October, the first interdisciplinary simulation took place with nutrition and nursing students caring for an elderly patient "personality" named Marilee Sweetwater. Teaching Electronic Medical Record (EMR) Use Informatics knowledge and skills are required by the American Association of Colleges of Nursing Baccalaureate Essentials, the Quality and Safety Education for Nurses competencies, and National Council Licensure Examination (NCLEX) testing. As clinical agencies attempt to meet their own requirements, students have had limited access to practice documentation and care planning using electronic medical records. The LRC has adopted the following technologies to help meet this need. • SimChart™ (formerly NurseSquared™) is an educational version that allows student use for data collection of information about their patients and then use to create a care plan that faculty can read and provide feedback. In fall of 2009 undergraduate students began using early educational EMR. Students and faculty beta tested this new technology in the simulation program in spring 2010. Starting this spring, 2012 SimChart became available for Adult Health, Women’s Health, Psychiatric, and Pediatric nursing students. • Samsung provided 29 Samsung 10.1™ tablets to the LRC to use for documenting care of a patient in an EMR during simulation. The students document their assessments and interventions using SimChart. Feedback was provided to both Elsevier and to Samsung on use of each of the products. This project was based on a proposal submitted to Samsung by an educational technology for evidence-based practice grant team. • Medication stations for use during simulation mimic medication stations found in hospitals. New Learning Technology Enhances Student Experience The profusion of new technology continues to enhance the delivery of quality clinical nursing education in the LRC and fits the technical capabilities of today’s students. Several additional applications are listed below: • Alaris CareFusion Smart IV™ pumps with “guardrails” system to safeguard the amount, volume and speed of certain drugs and fluids to keep patients safe. Students use the pumps in clinical labs and in caring for patients during simulations. This technology makes students more confident in using these tools when they work with patients in real-life clinical settings. • Sim Code ACLS™ online software guides students to the latest protocols for a variety of low-frequency, high-risk events in complex care. Students prepare for simulations with Coder Johnson, the LRC’s first simulation patient personality. • Sam the Auscultation Manikin™ is unique because it allows students to hear realistic sounds in the correct anatomical locations of the heart and lungs. An online version using the mouse to move the “stethoscope” is available through the Virtual LRC website. • Virtual LRC, which is available to students on the college website, stores more than 60 videos that are viewable from anywhere on any computer by graduate and undergraduate nursing students. This collection includes commercially and in-house produced video streaming titles. • The latest addition to the LRC simulation “patient” roles is an up-to-the-minute high-fidelity Laerdal™ manikin — SimMan Essential™. Students are already spoiled by his ability to blink his eyes and many more ‘human’ functions. The LRC plans to upgrade other manikins to this newer technology as funds are available. Spring 2012 9 dream • discover • deliver Maximizing Use of Investments The investment in additional space and technology have increased the need to maximize the use of Learning Resource Center facilities. To share ASU’s expertise in simulation and educate others, the LRC has conducted 11 Teaching Excellence in Simulation Education (TESE) workshops totaling 210 participants since 2006. This three-day intensive, hands-on workshop focuses on essential elements of scenario development and use of excellent educational practices in simulation education. The participants develop all aspects of scenarios for use in their own educational setting. They form objectives, create the case study, and program the software. Props and cues are developed to assure realism. On the third day, each team runs their scenario and then debriefs the participating volunteer participants. attend the TESE workshop over the period of the grant. The LRC also serves as a fertile environment for faculty research. For example, Dr. Joanne Olsen conducted research evaluating hand hygiene performance in the nursing clinical simulation environment. Dr. Rebecca Wilson also worked with senior students to research diagnostic reasoning skills in simulation. Measuring Competency with Simulation The National Council of State Boards of Nursing funded ASU, Scottsdale Community College and the Arizona State Board of Nursing in 2010 to research “Measuring Competency with Simulation.” Volunteer practicing nurses were filmed performing adult health simulations developed to provide the nurse with the opportunity to The Dream for the Future The simulation environment will be one of the places that students learn what it means to be part of an interprofessional team. Nurses, dentists, physicians, public health professionals, and pharmacists formed the Interprofessional Education Collaborative (IPEC) in 2009 to produce a report that provides guidance in developing the four domains identified as critical to IPEC to prepare future clinicians for teambased care of patients. The domains are: 1. Values/Ethics for Interprofessional Practice, 2. Roles/Responsibilities for Collaborative Practice, 3. Interprofessional Communication, and 4. Interprofessional Teamwork and Team-based Care. Nutrition faculty are already developing interdisciplinary simulations with nursing and other professions to help actualize simulation objectives based on the domains. IPEC will be a critical strategic initiative in the near future. Standardized Patient Program Instructors utilizing METI® Learning Space Federal Grant Supports Efforts The Health Resources and Services Administration funded “Leveraging Educational Technology for Evidence-Based Practice” (LET-EBP) grant has provided support for many of the changes in the LRC from 2008-2011. The grant assisted in developing numerous simulations, trained undergraduate faculty in debriefing and clinical judgment skills, supported 15 SimMentor faculty to develop over 20 reusable learning modules and was used to purchase several of the technologies described above. On a regional level, 160 preceptors in eight facilities were supported in an Evidence-Based Practice (EBP) workshop and six of these preceptors were funded to attend the College’s week-long EBP Mentorship program. Eleven educators from rural or underserved areas were provided tuition waivers to 10 display behaviors consistent with being a competent nurse. Nurses with experience in evaluating other nurses were trained to rate the simulations using the tool developed for this research. The result is a valid and reliable practice assessment which can support intervention on the public’s behalf in cases where the pattern of a nurse’s performance would likely result in harm to others. The Carnegie Report in 2010 recommended that practice skills be assessed for competency at the beginning of the final year of the nursing program and then again as the graduate takes the cognitive assessment (NCLEX) exam. Students are currently assessed at the end of Adult Health and during the last semester of the program. The curriculum research on these simulation assessments will help discover best practices to meet the Carnegie recommendations. Innovations in Nursing & Health Developing a Standardized Patient (SP) program for the undergraduate and graduate programs is part of the LRC plan. Standardized patients currently train medical students and physicians how to interview and examine patients. They play a role during the simulation or examination, either as a patient, a family member, or another member of the healthcare team. DNP programs as well as undergraduate nursing programs are beginning to develop SP programs across the U.S. to help create an even more authentic health care environment for students to practice. Competency Assessment of Practicing Nurses The LRC also will be able to conduct competency assessments for referred nurses through the Arizona State Board of Nursing soon utilizing the approach being developed with the MCWS research project. What the LRC will be Tomorrow The future is being built every day in the LRC at the ASU College of Nursing and Health Innovation. It is impossible to predict exactly what the LRC will be like in the future. However, it is certain that any changes will continue to create the best possible interactive clinical learning experience. Contributed by Ruth Brooks, MS, RNC, BC and Beatrice Kastenbaum, RN, MSN, CNE E lizabeth Reifsnider Nancy Melvin Pediatrics Professor Profile M any nursing professionals take years to decide where they want to center their careers. Their ambitions, skills, settings and experiences often help them reach the career space in which they want to work. However, Elizabeth Reifsnider, PhD, RN, WHNP, PHCNS-BC, FAAN, is among those nurses who defined their career space quickly. Reifsnider knew in her first year after graduation that community public health nursing was the place she wanted to be. Liz can best tell her story… “My BSN clinicals were doing home health and l loved home visits. After graduation and passing the NCLEX exam, I worked for 10 months as a staff nurse at a hospital in Oklahoma. However, I knew quickly that I wanted to work in a community with the public, not in an institutional setting. "When I started in public health, the public health nurses all had districts and we were expected to be in our districts several days a week, making home visits, holding clinics in church basements, organizing immunization drives, etc. I knew the mailmen on the rural routes and that’s how I sometimes was able to find a home, by asking them for directions. We also had schools assigned to us in our district and I was the school nurse for them and did their hearing and vision screening, head lice checks, conferences with teachers, etc. We really had to know something about everything, as we worked with pregnant women and made home visits on their newborns and with the elderly who we taught self-care for their chronic illness like diabetes, and with terminally ill, where we cared for them in hospice. "We addressed our clients’ health care needs at any stage of their health, from a primary prevention through to a tertiary prevention level. I felt that in public health nursing I was able to fully apply all that I knew as a nurse, both the independent actions as well as the delegated actions.” Reifsnider made career stops in Oklahoma, Missouri, and three Texas cities before joining the ASU College of Nursing and Health Innovation as the first Nancy Melvin Professor of Pediatrics for fall semester 2011. She joined ASU from the University of Texas Medical Branch at Galveston where she was the Constance Brewer Kommey Professor of Nursing and Associate Dean for Research. Since then she has reached out to the public health community in the Phoenix area to continue her passion for maternal/child nutrition and growth and community health. Twenty years ago, “Liz” Reifsnider expanded her career portfolio to teaching what she loves most — public health nursing — as an assistant professor at the Department of Nursing at Southwest Missouri State University. Since that time she has taught community/public health at BSN, MSN, and PhD levels, as well as in a MPH program in three states while continuing to volunteer services in community clinics and state and county health departments. She is currently teaching Social and Contextual Issues in Health at ASU, a first-year PhD course in the College of Nursing and Health Innovation. A certified Women’s Health Nurse Practitioner and a Public Health Clinical Nurse Specialist, board certified, for more than 30 years, Dr. Reifsnider has based her research on her practice for public health departments and WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) clinics. “I like the culture of working with nursing staffs and communities to assess health needs for diverse populations,” she added. Since joining ASU last year, Reifsnider has been busy building relationships with community and state agencies. “I am concentrating on integrating the strands of research, teaching and service together and learning the Arizona health community,” she said. The new Nancy Melvin Professor already has a grant titled “Evaluation of Baby Steps of Breastfeeding” from the Arizona Department of Health Services. She also has been named co-director with Professor Colleen Keller, the ASU Foundation Professor for Women’s Health, for the college’s T-32 Transdisciplinary Training in Health Disparities program funded by the National Institute of Nursing Research. Reifsnider has been impressed with the comprehensive nature of Arizona State University and the many opportunities it offers for collaboration with other disciplines such as nutrition, exercise and wellness, social work, and psychology. Within the college, she is impressed with the quality and strength of the Center of Improving Health Outcomes for Children, Teens & Families in which she sees her research expertise reflected in the work of many of her new colleagues. The professor also looks forward to working with the large Native American population in Arizona, a population with which she worked in Oklahoma, as well as the large Hispanic population. She already has formed a regimen of working every Friday at one of the college health centers that has a large patient base of younger Hispanic mothers. Not surprisingly, Elizabeth Reifsnider’s most significant professional and personal moments have come in the community and in patients’ homes in particular. “I am honored and humbled every time patients welcome me into their homes to help them and their families,” Liz Reifsnider said. The College of Nursing and Health Innovation also feels the same way — that she has chosen ASU as her new career home.  Spring 2012 11 dream • discover • deliver New Nutrition and Health Promotion Faculty Researchers Have Common Goal: To Move People T he School of Nutrition and Health Promotion welcomed three new faculty members this year: Steven P. Hooker, PhD, FACSM, Matthew Buman, PhD, and Eric Hekler, PhD. Although they have different backgrounds, unique perspectives, and diverse research interests, their common goal is to improve the overall health of society by getting people moving, making them more physically active and eating healthier foods. Much of their research focuses on the obstacles people face to achieving healthier lifestyles, and then applying what they learn to the real world through technology, community programs and public policies. By using cost-effective and efficient lifestyle and community interventions, the overall objective is to lower the risk of chronic disease rather than treat disease after the fact. “We want to invest in research that has the ability to make a significant and immediate impact on the health of our community,” explains Linda Vaughan, PhD, RD, FADA, director of the School of Nutrition and Health Promotion. Each has had great success in writing and executing nationally-funded research, something Vaughan believes will enhance research opportunities for the school. Their broad experience and expertise also will help the school build new programs and give students a broader range of faculty mentors to choose and learn from. Steven Hooker, phd, facsm Professor, Exercise and Wellness Steven Hooker isn’t exactly new to Arizona State University (ASU), graduating in 2002 with a doctoral degree in exercise science, but when he returned last year, it was a very different campus. “I was on the Tempe campus and didn’t branch out to experience the greater Phoenix area before,” says Hooker. “I really enjoy being 12 Innovations in Nursing & Health on the downtown campus now. There’s such a vibrant energy mixed with an incredible academic environment.” The concept of physical activity and its impact on health isn’t a new one. But Hooker believes there has been a shift from an individual approach to looking at broader social influences and environments. “It’s important to look at neighborhoods and the policies within our schools and government. That way, we can work with city and urban planners to make changes that impact thousands simultaneously.” Since Hooker was here last, metropolitan Phoenix has changed dramatically, including construction of the light rail system that was completed in 2008. Many minority populations live in the “It’s important to look at neighborhoods and the policies within our schools and government. That way, we can work with city and urban planners to make changes that impact thousands simultaneously. neighborhoods and new housing units built around the light rail system. Hooker is leading a research project to evaluate the environmental impact on the health of those residents by measuring lifestyle behaviors and health outcomes over time to see if they improve. The addition of sidewalks, lighting and treescapes in these areas may entice people to be outdoors and more active. Improved access to healthier foods and health care facilities may also help improve overall health. “The community is really engaged in this process, telling us what their issues are so we can come up with potential solutions,” explains Hooker. ” Hooker also wants to promote better health in middle-aged minority men, a vulnerable population that is more at risk for disease and more likely to die at younger ages. While at - Steven Hooker the University of South Carolina, Hooker was involved in a research project that helped determine the factors that influence physical activity in African-American men. In one-onone interviews, nearly all of those in the study expressed the desire to lead a healthier lifestyle. However, they felt that programs offered in the community didn’t target their needs or interests. They wanted programs that encouraged camaraderie, healthy competition and social interaction. A pilot program was developed based on their feedback, and Hooker hopes to develop a similar study looking at the Latino community in Phoenix. For the past three years, Hooker has also been involved in a large ongoing research project with several universities across the nation (ASU is the lead) examining physical activity and aging. With approximately 11,000 adults around the country wearing a monitor on their hip, their movements are measured over a week’s time. The subjects are then classified based on their activity levels, and will be followed over several years to monitor their health outcomes related to stroke, cognitive decline, cardiovascular disease, diabetes and other conditions. Hooker is excited about the changes taking place in the School of Nutrition and Health Promotion. The multi-disciplinary approach to improving health gives faculty and students the opportunity to work together on major health issues that face our society. “I’m excited to be in the midst of talented people who are all working towards a common goal. We’re not just sitting in our offices and classrooms. We’re out in the community, working to make it healthier and more vibrant.” Matthew Buman, phd Assistant Professor, Exercise and Wellness When Matthew Buman arrived at ASU in August, he was new to the desert. And because Phoenix attracts snow birds and retirees, it’s the perfect place for him to explore research opportunities in aging populations. “I want to help them regain function and do the things they’ve done their whole lives, even if it’s something as simple as walking out their front door to pick up the newspaper.” Buman explains that increases in even small amounts of physical activity, like performing household chores, can result in tremendous improvements in their physical and emotional health. He’s exploring ways that will help the elderly become more active. One of his research projects compared behavioral interventions involving older inactive adults. Would they be more likely to initiate and maintain more active lifestyles after receiving general health information and education, or when paired with an active older adult who served as a mentor in a group setting? After 18 months, the group with the peer mentor had maintained a higher level of physical activity, while those in the control group had reverted back to the same level of activity as when the study began. Using a volunteer peer mentor is not only more cost effective, Buman believes the group could relate to someone who understood the struggles of aging. He hopes to help develop similar programs in senior centers and exercise facilities across the Valley. Buman also is interested in environmental impacts on health behaviors. “Even if people want to change their behavior, they don’t always live in an environment conducive to that, which can be particularly true for older adults. They may Even if people want to want to eat healthier, but don’t have access to change their behavior, healthy foods. Sidethey don’t always live in walks, curb cuts, and an environment conducive even the timing of lights to that, which can be at intersections can also enhance or detract particularly true for older from it.” His research adults. They may want is looking at new ways to eat healthier, but to assess the environment, with older adults don’t have access to using devices similar to healthy foods. iPads, taking pho- Matthew Buman tos and audio recordings of their thoughts as they walk through their neighborhoods. The information is geographically coded, making it easier for policymakers to identify issues and prioritize funds to make improvements in those neighborhoods. “ ” Spring 2012 13 dream • discover • deliver His research also focuses on the more passive pursuit of sleep. Many midlife and older adults report sleep problems. Like physical activity, getting some decent “shut eye” has been shown to lower the risk of disease. But which is better for you in terms of preventing chronic disease? Is there an appropriate dose for each? And does that “dose” differ depending on age? “No one has really explored that balance, whether it’s better to have someone moving for 30 minutes or getting an extra 30 minutes of sleep,” explains Buman. “It’s very nuanced. We might find that there’s a different answer for stroke than there is for cancer.” It’s a relatively new area of study and Buman believes the more cutting-edge the research, the more likely it is to get funded — something that sets ASU apart from other universities. “There’s such a strong base of solid researchers here with up-and-comers forging a new path.” Eric Hekler, phd Assistant Professor, Nutrition Eric Hekler comes to ASU with a strong background in clinical health psychology. “I’ve always been intrigued by how thoughts, beliefs, ideology, and what exists within a person’s social network impacts health behaviors. I enjoyed being a therapist and feel there is a place for it but I personally think designing evidenceinformed technologies can have a larger impact on health behaviors,” he explains. While at Stanford University, Hekler worked with Drs. Tom Robinson and Christopher Gardner in a study titled “The Moral Eating Study” that examined whether or not moral and ethical issues related to food and its production would influence eating behaviors. A control group received basic health education about food. An experimental group was educated on sustainability of food and its production, labor issues, and animal rights. When preand post-eating behaviors were compared, the experimental group had improved their eating habits more so than the control group. The idea of motivation is something that often guides Hekler’s work. “Most people know they should eat better and exercise more. But it can be difficult. Often there’s no incentive or trigger. Sometimes people need a nudge.” He believes technology can help provide that “nudge” to improve health at a relatively cheaper cost than other alternatives. Hekler also led a research study with Dr. Abby King, his mentor at Stanford, that compared three different smartphone applications they developed to help determine which types are more likely to positively influence physical activity among older adults. One allowed users to set goals, then tracked how much time they spent sitting versus moving. Another consisted of a ‘live’ wallpaper that would compare the user’s physical activity at each moment to others — something meant to foster competition and collaboration. The third was a game, with a bird that would become playful and sing based on the user's activity level. Although still in the testing phase, Hekler hopes to someday make the applications available to the general public. “Many companies 14 Innovations in Nursing & Health are playing with these types of applications, but many are designed to sell and don’t necessarily equate to improved health of the overall population. We want people to be engaged for a long period of time.” The ability to translate research from the lab to the real world is one of the factors that influenced Hekler to come to ASU. “The school is very supportive of exploring options on how to improve and disseminate evidence-based practices through entrepreneurship,” says Hekler. It’s also refreshing to be in an environment that fosters collaboration among other schools and disciplines. Along with Daniel Rivera in the Ira A. Fulton Schools of Engineering and Matt Buman, he has submitted an application for a grant that uses ‘dynamic systems modeling’ to help speed the pace of scientific discovery. Says Hekler, “Maintaining a health behavior is what we want to create with our interventions to impact health, but current practices mean we have to wait a long time to know if the intervention worked. By using analytical methods and techniques, we can speed that process by using predictive models as proximal outcomes, accomplishing science more quickly and translating that to impact public health.”  “I’ve always been intrigued by how thoughts, beliefs, ideology, and what exists within a person’s social network impacts health behaviors. I enjoyed being a therapist and feel there is a place for it but I personally think designing evidence-informed technologies can have a larger impact on health behaviors. - Eric Hekler ” 1 dream • discover • deliver 2 Harnessing Technology to Fight Childhood Obesity Statistics on childhood obesity have become all too familiar. The prevalence of childhood obesity has more than tripled in the past 30 years.1 In 2009–2010, nearly 28 percent of non-Hispanic Whites and nearly 40 percent of Hispanic and non-Hispanic Black children and adolescents were overweight or obese.2 Causes of overweight and obesity in children include poor eating habits, increased sedentary activities, and inadequate engagement in even moderate physical activity. Overweight parents are more likely to have overweight children, who then are more likely to become obese adults.3 Obesity has been linked to health problems such as diabetes, hypertension, sleep apnea, breathing difficulties, chronic joint problems, or some cancers, and more than one can occur simultaneously.1,4 In terms of economics, one recent study estimated that if U.S. obesity rates were reduced by 5 percent, the United States could save $29.8 billion in five years, $158.1 billion in 10 years, and $611.7 billion in 20 years.5 To address these tremendous costs to society, education of the public and health professionals on the causes, costs, and consequences of the obesity epidemic is imperative. A New Collaborative Approach With a three-year, $1.18 million grant from the federal Agency for Healthcare Research and Quality (AHRQ), entitled “Health Information Technology to Support Clinical Decision Making in Obesity Care,” one team of pediatric researchers at the ASU College of Nursing and Health Innovation and the University of Colorado (UC) is pursuing a novel intervention. Its members use technology to help health care providers identify and assess overweight or obesity in children. Heading the team and principal investigator is Bonnie Gance- 3 1. Child or family uses iPad to answer questions about attitudes and behaviors toward making healthy changes, 2. Clinic staff compile summary and provide family with recommendations for healthy living tailored to habits and community resources, 3. Clinicians obtain risk summary and recommendations as well as information for labs and national guidelines. Cleveland, PhD, RNC, PNP, an associate professor and director of the Center for Improving Health Outcomes in Children, Teens & Families at the College of Nursing and Health Innovation. The expert interdisciplinary team includes nurse researchers and clinicians whose research is embedded in clinical practice: Lynn H. Gilbert, RN, PhD, PNP-C, UC College of Nursing, Aurora; Gabriel Shaibi, PhD, PT, a kinesiologist and assistant professor in the College; Diane Skiba, PhD, FAAN, FACMI, an informaticist, UC, Denver; Kevin C. Gilbert, PhD, an electrical engineer and president of HeartSmartKidsTM; Keri Bolton Oetzel, PhD, an expert in motivational interviewing, independent consultant; Laura Szalacha, EdD, a statistician/statistical consultant, Ohio State University; Danielle Dandreaux, PhD, project manager for the College; and Jinnette Senecal, BSBA, a web-based instructional specialist in Media, Instruction & Communication at ASU. Expert Panels Make Recommendations The team is building on national obesity guidelines for primary care providers (PCPs) to lead the fight against obesity. Among the groups that have convened panels to develop guidelines are the National Association of Pediatric Nurse Practitioners (NAPNAP); the American Medical Association (AMA) in collaboration with the Health Resources and Service Administration (HRSA); the Centers for Disease Control and Prevention (CDC); and most recently, an expert panel convened by the National Heart, Spring 2012 15 dream • discover • deliver Lung, and Blood Institute (NHLBI). These expert panels undertook comprehensive reviews of the literature concerning the current evidence about all aspects of childhood obesity.6,7 NAPNAP published its findings in a 2006 Journal of Pediatric Health Care (vol. 20.2, Supplement); the AMA/HRSA/CDC published its findings in a December 2007 supplement to the journal Pediatrics;8 and NHLBI, in December 2011 (www.pediatricnews.com). Dr. Gance-Cleveland chaired the NAPNAP Healthy Eating and Activity Together (HEATSM) research group evaluating the evidence, and Dr. Lynn Gilbert chaired the early childhood work group. Dr. GanceCleveland also was asked to become a part of the expert committee convened by the AMA, HRSA, and CDC. Experts have agreed that providers need to identify and assess overweight and obesity in children and adolescents; routinely calculate the body mass index (BMI) percentile for age and sex of the child and plot the measures on growth charts;4 include assessments of cardiovascular risks (e.g.; family history, nutrition, physical activity, blood pressure [BP], and smoking exposure) during well-child visits; and counsel children and families using behavioral counseling techniques such as motivational interviewing (MI). The AMA/HRSA/CDC committee added that children and adolescents should undergo various lab tests (e.g., a fasting lipid profile) and BP checks, especially when other risk factors were present, such as a family history of cardiovascular issues. NHLBI recently altered these recommendations, suggesting that all children 9-11 years of age have a cholesterol screening done and that fasting is not necessary for this test. Generating Evidence for Technology’s Role The team’s current work on strategies to improve care for overweight children began about 15 years ago, when Gance-Cleveland was providing care to children in a faculty practice within school-based health centers (SBHCs) in Colorado; in general, the children were poor and under-served and over 50 percent were Hispanic. She noticed the prevalence of overweight children and those with health issues related to obesity and that despite these patterns, providers were not following the guidelines on screening for these conditions. Moreover, providers were frustrated when they did identify and counsel youth on their weight at one visit, and then found that the youth had made no progress by the follow-up visit. Time and ease of use often present barriers for providers as they try to implement new guidelines. To address this issue, Dr. Kevin Gilbert was recruited to develop technology to gather history and calculate and plot BMI and BP. This became the HeartSmartKidsTM (HSKTM), a bilingual (English and Spanish) kiosk and decision-support system that assists providers. HSK automatically gathers behavioral and motivation information, generates and plots standard growth charts — including percentiles of BMI — and highlights relevant health risks on the HeartPrintTM, a summary of the child’s cardiovascular risk factors. Thus, providers do not need to do their own calculations and plotting on the charts, and the child’s cardiovascular risks factors are highlighted for the parents with the red heart. The child or family uses an iPad® or touchscreen kiosk to answer questions about their food, activity, sleep behaviors, and attitudes toward making healthy changes. Clinic staff add the height, weight, and BP measurements and print out two reports: one for the family and one for the provider. The family receives a risk summary with recommendations tailored to their habits and community resources for healthy living. The clinician gets the risk summary and recommendations, plus information on labs, MI, and other items from the national guidelines. Parents or patients who fill out the questionnaire in Spanish receive their information in Spanish. The HeartPrintTM provides a summary of the child’s cardiovascular risk factors based on their history and a decision support system that gathers information and generates standard growth charts, BMI, relevant health risks, and tailored recommendations. 16 Innovations in Nursing & Health Dr. Lynn Gilbert observed, “One aspect of the HeartSmartKids interaction with families that is difficult to capture without observing its use is the ‘delight’ factor when children and parents share information while completing the on-screen interview. That begins a discussion that can continue with the provider, HeartPrint in hand. All are then focused on the family’s health and behaviors to identify healthier changes and what might work best for the family.” The HSK was pilot tested in a 2008 study in one SBHC: a nurse-managed primary care clinic operated by a college of nursing in a Rocky Mountain state. A random sample of 15 percent of charts (every eighth chart) of active patients seen for wellchild visits for children and adolescents 3-20 years were evaluated for documentation of cardiovascular risk factors. Findings suggested that providers sometimes failed to record information critical to assessing obesity. After the team introduced the HSK system in 2008, however, there was significant improvement in documentation of BMI, increasing from 36 to 86 percent; of BMI percentile, increasing from 31 to 76 percent; of BP, increasing from 82 to 97 percent; and of BP percentile, increasing from 1 to 35 percent. New Opportunities with the AHRQ Grant The current AHRQ grant is a comparative effectiveness trial comparing web-based training with and without the technology support (HSKTM) for providers in 24 SBHCs in six states (AZ, CO, NM, NY, NC, and MI). Guiding the study are the health disparities collaborative and chronic care models. The web-based training is designed to increase providers’ understanding of the current obesity guidelines and use of motivational interviewing (MI); it includes learning sessions and the use of the Institute for Healthcare Improvement’s strategies for rapid-cycle change to monitor practice quality. “Motivational interviewing is a technique that acknowledges the difficulty in changing behavior,” Dr. Gance-Cleveland explained. “In MI, the provider elicits goals and explores the discrepancy between current behavior and desired health goals. The process includes establishing rapport, assessing behavior and motivation for change, and tailoring the approach to counseling based upon readiness.” The training is available on a passwordprotected social media website (Ning) and includes voiced PowerPoint® presentations on the obesity recommendations, the chronic care model and model for improvement, and case-based video vignettes that demonstrate the MI counseling technique for providers. Evaluation of the training consists of the provider’s self-report of knowledge, attitudes, and behaviors; parents’ satisfaction with visits; and providers’ documentation of cardiovascular risk factors in terms of the current guidelines at baseline, at completion of the intervention, and one-year post intervention. As of this writing, the team has finished collecting baseline data from all the sites and has audited data from charts of 791 children, 5-12 years old (48 percent male and 49.4 percent female; 30.8 percent White, 13.3 percent Black, 0.5 percent Native American, 42.2 percent Hispanic, 0.8 percent Asian, 3.7 percent mixed, and 1.1 percent other); 54.8 percent from rural SBHCs and 45 percent from urban centers. Baseline data point to room for improvement. The team is seeing significant differences between Graduate nursing scholars use technology to improve the calculation of BMI from height health care delivery. and weight and the providers’ REFERENCES diagnosis of obesity (p<.0001) and overweight (p<.0001). Providers missed 1. CDC. Childhood obesity facts. www. the overweight diagnosis in 13.2 percent cdc.gov/healthyyouth/obesity/facts.htm. (n=78) of cases, and missed the diagnosis Updated 2011. of obese in 14.2 percent (n=83) of cases. 2. Ogden CL, Carroll MD, Kit BK, Flegal There were also significant differences KM. Prevalence of obesity and trends between the children who met criteria for in body mass index among US children having labs ordered and those who actuand adolescents, 1999-2010. JAMA. ally had labs ordered (p<.0001), with 2012;307(5):483-490. 28.9 percent (n=13) of those diagnosed with obesity not being referred for labs. 3. Kral TVE, Faith MS. Influences on child Team members expect to see better adherence to the guidelines when they return to collect new data after the training is done. Providers started the online training in November 2011 after completion of baseline data collection, and satisfaction with the training has been high. Parents rated satisfaction with care “good” to “very good”. Team members anticipate improvements in provider’s knowledge, attitudes, and behaviors; adherence to guidelines per chart audits; and improved parent satisfaction. Building on a Strong Foundation As Dr. Kevin Gilbert noted, “The explosion of touchscreen tablet technology has allowed us to bring touchscreens to each clinic.” He continued, however, that while “technology has the power to radically improve the provision of health care, it isn’t a panacea.” Technology has to work well for both the provider and the family, improving relationships and providing more high-quality information for better health. This study will allow the investigators to determine if training alone is sufficient to change practice or if the addition of the technology support will add to the improvement in evidence-based health care being delivered. This team will continue to refine its novel approach, and its members intend to make major contributions to fighting obesity in their collaborations to come.  eating and weight development from a behavioral genetics perspective. Journal of Pediatric Psychology. 2009;34(6):596605. 4. CDC. Overweight and obesity. www. cdc.gov/obesity. Updated 2011. 5. Levi J, Segal LM, Salay R. Bending the obesity cost curve. Trust for America’s Health. http://www.healthyamericans.org/ report/93/. 2012. 6. Barlow SE, the Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics. December 2007;120(Supplement 4):S164-S192. 7. Gance-Cleveland B, Gilbert LH, Kopanos T, Gilbert KC. Evaluation of technology to identify and assess overweight children and adolescents. Journal for Specialists in Pediatric Nursing. 2010;15(1):72-83. 8. John-Sowah J, the Expert Committee, et al. Assessment of child and adolescent overweight and obesity. Pediatrics. December 2007;120(Supplement 4):S163-S288. Contributed by Nancy Moore, Grant Writing Resource Specialist, Health Solutions Spring 2012 17 AONE Funds Fellowship and Transdisciplinary Consortium for Innovation Leadership in Health Care at Arizona State University The American Organization of Nursing Executives (AONE) and the Arizona State University (ASU) College of Nursing and Health Innovation announced the formation of the Transdisciplinary Consortium for Innovation Leadership in Health Care. As their first official action, the consortium partners announced the launch of the Fellowship in Innovation Leadership in Health Care, a 15-month program for senior health care leaders. The Fellowship program, which will begin in September 2012, is designed to prepare the most innovative leaders to positively impact the future of health care. Participants will be mentored by a group of nationally recognized leaders including Barbara Balik, EdD, RN; Jack Gilbert, EdD, FACHE; Kathy Malloch, PhD, MBA, RN, FAAN; Tim Porter-O’Grady, DM, EdD, FAAN; Barry Silbaugh, MD, MS, FACPE; Donna Sollenberger, EVP and CEO, UTMB; and David Webster, Partner, IDEO. Pamela Thompson, Chief Executive Officer AONE The purpose of the Fellowship is to strengthen fellows’ personal capability to lead and sustain innovation through bold projects that will accelerate their organization’s capability to innovate and measurably improve health outcomes, patient and community satisfaction, caregiver satisfaction and productivity, transdisciplinary collaboration, and financial health. The Fellowship program features: • A focus on the leadership mind-set and skill set that will strengthen and sustain a culture of innovation, • A phased approach to innovation that allows fellows to reflect and learn (in immersions and webinars) and to accelerate realization of results (through projects and mutual support), • Enhanced learning and networking through diverse views, experiences, and disciplines of fellows, and • Learning that is shared “back home” in fellows’ individual organizations to strengthen their organization’s capability to innovate and improve outcomes. “It is critical that our health care leaders are experts in innovation. AONE has always been committed to the development of leaders, not only for today, but for the future. Our mission is to shape health care and part of that shaping has to include the science of innovation and its application to our health care system. It is even more important that we do this in partnership with other health care leaders,” said Pamela A. Thompson, MS, RN, CENP, FAAN, AONE chief executive officer. “This Consortium will bring together a multidisciplinary team to learn together, and more importantly, to change our systems. We are pleased to announce the funding of the Consortium and the launch of the fellowship program.” Teri Pipe, dean of ASU’s College of Nursing and Health Innovation, added, “The Transdisciplinary Consortium’s Fellowship in Innovation Leadership in Health Care is perfectly aligned with the Health Solutions initiative at ASU to address major recognized state and national issues. We are grateful to AONE for its sponsorship and honored to be their partner.” Transdisciplinary Consortium Mission The Transdisciplinary Consortium for Innovative Leadership in Health Care provides venues, programs and forums that offer exceptional opportunities to instill the mindset and skills for leading transformation and innovation in service of positive organizational and health outcomes; promotes the timely implementation of evidence-based decision making, a critical leadership capability; and creates synergy between theory, research and application that extends new knowledge about health care leadership into practice. AONE Voice of Nursing Leadership AONE is the national professional organization for nurses who design, facilitate and manage care. With more than 8,500 members, AONE is the leading voice of nursing leadership in health care. Since 1967, the organization has provided leadership, professional development, advocacy and research to advance nursing practice and patient care, promote nursing leadership excellence and shape public policy for health care. AONE is a subsidiary of the American Hospital Association (AHA). For additional information, visit the AONE website at www.aone.org. Jack Gilbert, Consortium Director Fellowship Applications Applications for the first cohort of Fellows are currently being accepted. Early applications are encouraged due to the uniqueness of the program and a limit of 20 in the first cohort. For more information about the program go to: www.leadhealthcareinnovation.com or contact Jack Gilbert, consortium director, at Jack.Gilbert@asu.edu. Founded in 1957, the College of Nursing and Health Innovation (http://nursingandhealth.asu.edu) has nearly 1,400 students and more than 9,200 alumni. It is ranked 21st out of 467 (top four percent) of graduate nursing programs in the nation, according to the 2012 U.S. News & World Report Best Graduate Schools Programs. The College offers the only dedicated interdisciplinary Master of Healthcare Innovation degree program in the United States.  18 Innovations in Nursing & Health Mayo Clinic ASU Nursing Program Partnership Built to Last Strategic partnerships are like friendships. Some last and some don’t. However, an evaluation of the Mayo Clinic and ASU College of Nursing and Health Innovation partnership formed six years ago shows the signs of a long-term commitment. Teri Pipe, PhD, RN, dean of the College of Nursing and Health Innovation, explained that the catalyst for the partnership was the critical nursing shortage in Arizona. To address the shortage and with many well-qualified students waiting to enter, the College of Nursing and Health Innovation expanded program capacity. The partnership has the additional benefit of utilizing practicing nurses’ knowledge and skills at an optimal level, which is one of the recommendations of the latest Institute of Medicine report. During this time, Rita Jury, MSN, RN, CPHQ, then director of Clinical and Patient Education, and Vicki Buchda, MS, RN, NEABC, former vice chair, Division of Nursing Services, Mayo Clinic, contacted Mary Killen, former associate dean for Academic Affairs, to suggest an ASU nursing site on the Mayo campus. “They wanted to help address the shortage and at the same time provide opportunities for their masters-prepared nurses to teach,” Killeen explained. “This was fantastic since a major obstacle to expanding enrollment was finding qualified faculty and clinical placements. Mayo could provide both!” facilities, and clinical experiences for students in their adult health, complex care, and clinical immersion rotations. From the beginning, the Mayo campus cohort of 20 nursing students has been outstanding. Mayo students have demonstrated high retention and graduation rates and a 99 percent pass rate on the NCLEX licensing exam, which is well above state and national rates. In addition, the program does not require a payback obligation for students to work for Mayo following graduation but most Mayo Campus nursing graduates apply to work there. Of the most recent graduating cohort of 20, 19 applied and 12 were offered positions at Mayo. One of the 12 offered a position declined. Partners Work Closely to Find Solutions Mayo Clinic in Arizona does not provide inpatient obstetric, pediatric and psychiatric services — important parts of the nursing education curriculum. However, the partners worked hard to meet faculty needs by identifying ASU faculty to teach those courses. The purpose of the joint nursing education program remains to increase enrollment capacity for nursing students in Arizona through the use of the combined resources and clinical strengths of both institutions. Under terms of the arrangement, ASU has provided the curriculum, clinical planning, and program oversight. Mayo provides qualified nurses who serve as faculty, classrooms, clinical learning lab OB Course Coordinator Pamela Silva, RN (center) and current ASU nursing students take a break from class at the Mayo Clinic campus in Phoenix Spring 2012 19 works for Mayo in Wisconsin, reflects on the nursing program with pride. “The program fused the academic excellence of ASU with the clinical strengths of Mayo,” Jury said. “Mayo faculty infused current day practice into the teaching and created a model with ASU that resulted in better care for patients.” Students Seek Values Jennifer Burkmier, a second-degree student who graduated in May and now works at Mayo, was initially attracted to the nursing program because of its 16-month schedule and the privilege to study at Mayo. However, what Burkmier found there exceeded anything she could have hoped for. “Each instructor is a leader in their field and they provide students with the support and education needed to produce the highest quality of nursing graduates,” Burkmier said. “Small class sizes and the consistency of professors throughout the program cultivate a feeling of family that has been a critical component of my success. I can honestly say that I feel very honored to have been a part of this experience and could not have received a better nursing education anywhere.” The ASU college also works with Mayo Clinic to fill other unexpected gaps in faculty needs by drawing from its pool of qualified educators. Bella Panchmatia, MS, RN, was appointed as the permanent site coordinator in 2006. With previous experience at Mayo Clinical Hospital and the ASU College of Nursing and Health Innovation, Panchmatia has proven ideally suited to coordinate the partnership. In her tenure as on-site program coordinator, she has seen 93 nursing students graduate with their Bachelor of Science in Nursing degrees with 34 graduates currently working at Mayo. One cohort of 20 students is currently in session. Panchmatia noted that continuing enhancements have made the program more comprehensive in the past six years. The opening of the Virginia Nehring Utz Nursing Clinical Skills Laboratory in 2010 and larger, more mediated classroom space that is shared with other Mayo Clinic departments, represent significant program additions for students and faculty. Now student clinical labs and simulation can be conducted on site instead of at the former nursing labs on the ASU West Campus. “The greatest rewards from my work as site coordinator are to help prepare the next generation of nurses and to be involved with them on a daily basis,” Panchmatia said. Rita Jury, one of the partnership principals and who now 20 Innovations in Nursing & Health Teresa Connolly, MSN, RN, NE-BC, chief nursing officer/ chair, Division of Nursing Services at Mayo Clinic, said the partnership with the ASU College of Nursing and Health Innovation has provided sustainable benefits to Mayo Clinic in Arizona. “Students in the program are being taught by nurses practicing in the field and become educated in the Mayo culture of quality patient care,” Connolly explained. “The program has helped to develop the 40 Mayo nurses who have served as adjunct faculty by providing additional opportunities to teach and adding to their job satisfaction, which helps Mayo retain them.” Connolly believes that the Mayo Clinic–ASU model for nursing education will continue to grow in the future. “Nursing is the largest single group of care providers and will play a major role in reforming the nation’s health care system,” the CNO said. “Teaching based on a shared belief in nursing education that provides the highest quality care for patients is at the heart of Mayo and ASU nursing cultures,” ASU’s Killeen added. “That is what makes this such an effective partnership.” Dean Pipe pointed to the Mayo Clinic–ASU nursing program partnership as one of the early successes of the institutional ASU/Mayo relationship. “Other clinical and research partnerships have grown from this first success and we have many more exciting opportunities ahead for other collaborative endeavors,” the ASU nursing dean said.  Spotlight Luxana Reynaga, PhD ASU Nursing Celebrates First International PhD Graduate Luxana Reynaga-Ornelas received her baccalaureate nursing degree from the College of Nursing and Obstetrics at the University of Guanajuato at León in 1993 and then received specialized training in Critical Care Nursing at the College, University of Nuevo León in Monterrey, Mexico. She also received a MS in Nursing at the University of Nuevo León. Since 2004, Luxana has been an associate professor at the University of Guanajuato College of Nursing and Obstetrics, León campus. In 2008, she entered Arizona State University to pursue her PhD in Nursing & Healthcare Innovation. She has been a member of Sigma Theta Tau International (STTI), Beta Upsilon Chapter since 2007. Luxana has co-authored a peer-reviewed paper and book chapter on sleep and health of U.S. minorities and has presented numerous papers and posters at national and international conferences. Dr. Reynaga answers questions about her accomplishments: How do you feel about being the first international student to earn a PhD in Nursing at ASU? It is a great honor and responsibility to be the first international student and the first Mexican nurse to earn the PhD in Nursing & Healthcare Innovation at ASU. I am proud to let Arizona, the U.S., and the world know that it makes no difference to be from one country or another. We are intelligent and hard working people. We have dreams and we do whatever it takes to make them come true. I feel proud because this achievement took huge personal effort. It also recognizes the people who supported me financially, emotionally and academically. I was not able to obtain a scholarship from the Mexican government for the first two years of study but received a Bardewyck Scholarship instead. I was able to obtain a scholarship from the Mexican Ministry of Education to complete the final one and one half years of the program. University of Guanajuato León Campus Rector José Luis Lucio-Martínez and the dean of the School Nursing and Obstetrics Department Cipriana CaudilloCisneros also supported me academically. Have you applied the knowledge gained from your study at ASU in your current career in Mexico? I did that since the first day of the program. I was able to discuss and bring new knowledge to the table in a way that applied to different situations in Mexico. For example, I have applied the web-based class version in my own teaching. As a professor, I learned that one of the most important clues with the way that mentors and instructors motivate students is by highlighting their strengths and clarifying their weaknesses. As a researcher, I was also able to ask my own questions and write my own proposal, which has local and maybe national implications for quality of care and policy changes in Mexico. What is your career goal now that you have earned the PhD degree? I have returned to my role as a professor at the University of Guanajuato. Publishing the results from my dissertation is the first challenge, as well as applying to become a member of the National System of Researchers in Mexico. I also want to continue to develop my research in healthrelated quality of life and sleep disorders for persons with chronic diseases. A long-term goal would be a postdoctoral position to expand my knowledge. What is unique about the PhD program offered by the College of Nursing and Health Innovation? It is the way the program was designed, its hybrid nature, the flexibility to build a personal career path, and the PhD program faculty expertise at ASU. What was your biggest challenge in your program of study at ASU? Language was definitely a barrier since English is not my first language. Although I met TOEFL requirements, my English learning had been based on classroom courses. I struggled with some idioms, slang and academic jargon during my courses. Each paper took me longer to complete compared with American students. However, I had excellent classmates and instructors who were always there when I needed help. I want to recognize the support from the program assistants who helped me to understand an entirely different academic system with many processes and deadlines. Do you have suggestions for improvement in the PhD program? One of the biggest issues for me was the visa status qualification, which was neither an international student visa nor a tourist Drs. Carol Baldwin, Luxana Reynaga and Pauline Komnenich visa even though I was an international student. Coming and going to and from the country was difficult along with implications for health insurance coverage. The PhD program must solve this challenge for international students to take part in a hybrid program. Another suggestion would be to analyze the role of the mentor in the completion of the course work and research. It was clear to me since the first day until graduation that the guidance obtained from my mentor and chair, Dr. Carol Baldwin, was crucial to organizing and completing my comprehensive exams and dissertation. Are there faculty and mentors that you want to acknowledge? My instructors contributed to my learning and research project in many ways. I have to acknowledge my awesome dissertation committee members; Dr. Stuart F. Quan, who honored me with sharing his vast experiences as an expert in sleep research, and Dr. Kimberly Arcoleo, who worked through the statistical analysis with me, always with strong support and kind advice. In particular, I want to acknowledge my mentor and chair, Dr. Baldwin. I could have never completed the degree without her expertise, precious time, and guidance as a researcher and person. She knew the difference between being free to research in some topic compared to being lost in topics for research. How did your husband support you in obtaining your doctoral degree? My husband, Gerardo was mom and dad for our four children under age 13 since my mind and time was totally focused on my studies. He lovingly explained my absence during our children’s school meetings, and family and birthday parties. He did the grocery shopping, dressed the children, and continued with his own job. When I ask him about my achievement he says, “We are proud of you because you are always looking to be a better person.”  Spring 2012 21 A Legacy for the Spirit of Life Occasionally a person crosses our path leaving a lasting impression because they exemplify the Spirit of Life itself. JB (Jonathan Bently) Metzger was such a person whose life ended all too soon in a vehicle accident at age 28 — but oh, what a legacy he left through the lives he touched, and now the generosity of his parents Stephanie and Clay Sherman of Carefree, Arizona. The Shermans have made an outright nursing scholarship donation in JB’s name, and the largest estate gift in the history of ASU’s College of Nursing and Health Innovation. They chose to support the nursing profession as symbolic of the Spirit of Life, and to help nurses understand that the spirit of who they are is as important as the work they do. Connection to ASU Their connection to ASU began when the Shermans moved to the Scottsdale area from Chicago. Their son JB enrolled in ASU in 2001, graduating in 2004. Their proximity enabled them to witness JB in school and his early career. What they say about his life gives a clear picture of who he was and why they want his spirit to live on through others. Balancing the needs of others with business “Once someone met JB, he was their friend for life. He astonished many at what he was willing to do for them,” Stephanie Sherman said, adding that JB balanced the needs of others with the business of a mortgage company he founded. “He did a lot of pro bono work to help others be able to have a home. For one young widow JB gave up his earnings so she could lower her payments to avoid foreclosure. She honored him by attending his funeral service and placing a photo 22 Innovations in Nursing & Health Once someone met JB, he was their “ friend for life. He astonished many at what he was willing to do for them.” of her children and the small home she purchased with his help on his grave. On another occasion he took an old horse in trade as collateral for an elderly widow who insisted on paying her way in some fashion to finance her home to an affordable level.” scholarships show the same Spirit of Life in their Clay Sherman added that JB exemplified Dickens’ words: “We are so very grateful to the Shermans for this “Business! Mankind was my business. The common welfare was my business; charity, mercy, forbearance, and benevolence, were all my business. The dealings of my trade were but a drop of water in the comprehensive ocean of my business!” Stephanie described her son as honest, ethical, and graced with the common touch. He had a tremendous work ethic, and saw the best in people, she said. His co-workers and friends knew JB as greatly enthusiastic who often made them laugh by spontaneously breaking into song. careers that JB did,” Clay Sherman said. “Stephanie and I want JB’s Spirit of Life to live through what they do in helping others.” generous gift,” Teri Pipe, dean of the College of Nursing and Health Innovation, said. “It is inspiring that they have transformed their personal loss into a meaningful legacy that will have such impact since each scholarship recipient will have the opportunity to have a positive effect on so many lives throughout their nursing careers. The ripple effect of the Sherman’s gift will be strong and enduring.”  Spirit of Life Scholarship The Shermans expressed their son’s Spirit of Life in the scholarship’s criteria. “JB stood up for the underdog,” his mother said. “He believed in helping others by giving a hand up so we prefer that the scholarships be used for students with exceptional needs—those needing a hand up.” The Shermans have also established the JB Metzger Spirit of Life Foundation (http://www. spiritoflifecharity.com) to assist further efforts to support nursing education, with a current project to raise money to fund ASU’s doctoral program in nursing practice. “We hope the students who receive these Stephanie and Clay Sherman Spring 2012 23 dream • discover • deliver Hartford Center Graduates and Scholars Establish tradition of nursing excellence The ASU College of Nursing and Health Innovation Hartford Center of Geriatric Nursing Excellence (HCGNE) is one of only nine centers funded by The John A. Hartford Foundation and its Building Academic Geriatric Nursing Capacity program (BAGNC) at the American Academy of Nursing. As an HCGNE, Arizona State University is proud to be part of the broader Hartford Geriatric Nursing Initiative (HGNI). Since 1995, through a $67 million investment from The Hartford Foundation, the HGNI and its component programs across the country have been preparing nurse educators to teach the next generation of nurses to provide health care to older adults. The mission of ASU’s College of Nursing and Health Innovation Hartford Center of Geriatric Nursing Excellence is to significantly increase the number of high-quality From left: Mentors Dr. Johannah Uriri-Glover and Dr. David Coon doctoral and postdoctoral level faculty in confer with Hartford Scholar Angela Allen. geriatric nursing needed to teach in graduate and undergraduate academic nursing programs throughout Arizona and surrounding Southwestern states. The ASU College of Nursing and Health Innovation is proud to present its first cohort of Hartford Center of Geriatric Nursing Excellence graduates and to introduce the exceptional Hartford Scholars, recipients of the College of Nursing and Health Innovation HCGNE Pre-Doctoral Fellowship, HCGNE Banner Health Pre-Doctoral Fellowship, or HCGNE Evercare Pre-Doctoral Fellowship who are continuing along the path of nursing excellence. ASU College of Nursing and Health Innovation Hartford Center of Geriatric Nursing Excellence Kathi Lindstrom, PhD, FNP-BC, ACHPN, HSMI, is an assistant professor of nursing at Vanderbilt University and the Palliative Care focus coordinator in the Adult Nurse Practitioner program. Dr. Lindstrom has more than 15 years clinical experience in hospice and palliative care. She holds a Bachelor of Science in Nursing from Oregon Health Sciences University, and a MS in Nursing and Doctor of Philosophy (Nursing) with a Certificate in Gerontology from Arizona State University. Lindstrom is a board certified family nurse practitioner, advanced practice certified in hospice and palliative nursing, and is 24 Graduates certified as a holistic stress management instructor. Lindstrom’s doctoral work focused on family caregivers and her dissertation tested an intervention for family caregivers of newly admitted hospice patients. Adriana Perez, PhD, ANP, is an assistant professor and Southwest Borderlands Scholar at the ASU College of Nursing and Health Innovation. A graduate of the first PhD cohort at the college, she received funding to support her doctoral dissertation from the John A. Hartford Foundation (BAGNC) program; the National Institutes of Health/National Institute of Nursing Innovations in Nursing & Health Research through an Individual Nursing Research Service Award; Beta Upsilon Chapter of Sigma Theta Tau International; and the National Coalition of Ethnic Minority Nurses. In 2009, she was awarded a John A. Hartford Foundation Claire M. Fagin Fellowship for postdoctoral training as a geriatric nurse scientist. Dr. Perez’s research focuses on cardiovascular health promotion among older diverse populations. She has developed and tested a theory-based motivational intervention to promote physical activity among older Hispanic women in the Phoenix metropolitan area. In the health care policy area, Perez focuses on the translation of effective interventions that promote healthy aging in sustainable community programs. Janet Purath, PhD, APRN, BC, is an associate professor at the College of Nursing at Washington State University. Dr. Purath earned a Bachelor of Science in Nursing degree from Jamestown College, a MS in Nursing and Primary Care from Indiana University, and a Doctorate from the University of Illinois at Chicago. She completed a postdoctoral fellowship in research in physical activity and older adults at Arizona State University and from the John A. Hartford Foundation. Purath served as a faculty member in the School of Nursing at Purdue University. Her teaching experiences are in health assessment, clinical supervision, primary care of the older adult, and nursing research. Her clinical practice includes care of adults in the intensive care unit, home health nursing, women’s health, and rural primary health care. Purath’s work focuses on chronic disease prevention, and physical activity and function in older adults. Carol Rogers, PhD, APRN-BC, is an assistant professor in the College of Nursing, University of Oklahoma Health Science Center. She is a Barbara Browne Connors Scholar and holds her Bachelor of Science in Nursing, MS in Nursing, and Doctor of Philosophy (Nursing) from ASU. Rogers is a board certified clinical nurse specialist in Public/Community Health. She received funding for her dissertation research titled “Sign Chi Do Exercise for Adaptation to Aging” from the John A. Hartford Foundation BAGNC program and the National Institutes of Health/NINR through an Individual Nursing Research Service Award. In 2011, her dissertation research was awarded the National Council on Aging’s National Institute of Senior Centers’ Annual Research Award. Rogers’ clinical practice includes community health and acute care of adults with experience as a clinical educator for perioperative services. Prior to her current position, she was awarded a 2010 College ASU College of Nursing and Health Innovation Hartford Center of Geriatric Nursing Excellence Angela Allen, RN, BSN, MAT, EdS, EA, CRRN Mentors: David W. Coon, Colleen Keller, and Johannah Uriri-Glover Addressing the Unmet Needs of ADRD Patients in a Rehabilitation Setting Jennifer Barrows, RN, BSN, CPAN Mentor: Julie Fleury Physical Activity and Health Promotion for Hispanic Women Laura Blank, MSN, RN Mentor: Nelma Shearer Health Empowerment Intervention with Rural Mexican-American Older Adults Marina Bradberry, BSN, RN Mentor: Marianne McCarthy Health Promotion for Successful Aging through Diet and Exercise of Nursing and Health Innovation Hartford Center of Geriatric Nursing Excellence Banner Health Postdoctoral Fellowship. She worked on the development and refinement of a theoretical model integrating psychosocial and physiological factors impacting functional outcomes related to healthy aging and led recruitment efforts by serving as chair of the ASU HCGNE Diversity Recruitment and Retention Committee. Amy Silva-Smith, PhD, ANP-C, is an associate professor at Beth-El College of Nursing & Health Sciences, University of Colorado in Colorado Springs. A 20092011 John A. Hartford Foundation/Claire M. Fagin Postdoctoral Research Fellow mentored by Dr. Julie Fleury, Silva-Smith conducted a randomized controlled trial of a wellness motivation intervention to reduce stroke risk factors in older adults. Dr. SilvaSmith’s ongoing research and clinical work focuses on promoting health and reducing functional limitations in older adults. She is director of research for the UCCS/Palisades Senior Housing Facility Partnership in Colorado Springs, Colorado.  Scholars Cherrié Holland, MSN, RN Mentor: Karen Marek Treatment of Acute and Chronic Pain of Older Adults in Clinical and Community Settings David Hodgins, MSN, RN Mentor: Colleen Keller Health Disparities in the Aging Native American Population Kari Zimmerman-Johnson, MSN, RN Mentor: Julie Fleury Motivating and Sustaining Physical Activity in Older Adult Hispanic Women Anne Marie O’Brien, MSN, RN, WHNP-BC Mentor: Karen Marek Understanding Medication Adherence in Community-Dwelling Older Adults: An Analysis Using a Mixed-Methods Design Stacey Nseir, BSN Mentor: Linda Larkey Bereavement and Physical Activity in Older Adults Lorenza (Lori) Murphy, MSN, RN Mentor: Shannon Dirksen Oncology Care of Older Patients Ebere Ume, MSN, RN Jonas/Hartford Scholar 2011-2013 JAHF BAGNC Scholar Mentor: Bronwynne Evans Post-Caregiving Transitions in African American Caregivers Kathy Ward, MSN, RN Mentor: Nelma Shearer Optimizing Well-being in Caregivers of a Spouse with Dementia Spring 2012 25 Nursing and Nutrition Leaders Receive Dream ∙ Discover ∙ Deliver Awards Three nationally prominent leaders received the Dream, Discover, and Deliver Awards at the annual program hosted by the College of Nursing and Health Innovation and the School of Nutrition and Health Promotion in Phoenix last December. Now in its fourth year, the program is an annual event featuring three honorees dedicated to improving health care and the health of the American public, each of whom leads change through innovation to achieve their goals. The 2011 award winners are: Dream Award Anita L. Owen MA, RD President, Owens & Owens Ltd. “Be energetic, enthusiastic and always empathetic. These traits will fuel your dreams and will help you make the invisible the inevitable.” Anita L. Owen received the Dream Award at the program. As a leading nutrition education authority and consultant, Mrs. Owen has a breadth of knowledge gained by experience in public health, industry, academe, and professional associations. She was director of the Arizona Department of Health Services Leadership Academy when she was awarded the First Prize in Leadership Development by the Association of State and Territorial Health Officers. She was the first chief nutritionist for Arizona and gained recognition in the field of public policy at both state and national levels. Nationally Owen was one of the major architects of the Supplemental Feeding Program for Women, Infants and Children (WIC). As senior vice president of the National Dairy Council (NDC), she was responsible for managing NDC Nutrition Education and Research programs including the development of heart-healthy educational programs for the public. An authority on community nutrition, she co-authored the classic health education textbook Nutrition in the Community — The Art and Science of Delivering Services. Discover Award Patricia A. Grady PhD, RN, FAAN Director, National Institute of Nursing Research “The future of health care rests squarely … on your drive; your intellect and expertise; and on your passion for scientific inquiry and its translation into evidence-based practice and health care policy.” Patricia A. Grady received the Discover Award for her national leadership in advancing nursing science. Dr. Grady, appointed Director of the National Institute of Nursing Research (NINR) in 1995, earned her undergraduate degree in nursing from Georgetown University, and earned a MS in Nursing and a doctorate in physiology from the School of Medicine at the University of Maryland. Before joining NIH, Grady held several academic positions and served concurrently on the faculties of the University of Maryland School of Nursing and School of Medicine. She is a member of several distinguished scientific organizations, including the Institute of Medicine, Society for Neuroscience, American Academy of Nursing, and American Neurological Association. Grady also is a fellow of the American Heart Association Stroke Council. An internationally recognized neuroscience researcher, Dr. Grady has authored or co-authored numerous published articles and papers on hypertension, cerebrovascular permeability, vascular stress, and cerebral edema. She lectures and speaks on a wide range of topics, including future directions in nursing research, developments in the neurological sciences, and federal research opportunities. Deliver Award Jo Elizabeth “Joey” Ridenour “Delivery is being the voice of the patient and for the profession … MN, RN, FAAN (ASU ’69) Executive Director, Arizona State Board of Nursing always have the patient as the centerpiece of any decision.” Jo Elizabeth “Joey” Ridenour, received the Deliver Award for her outstanding record of nursing administration and leadership in Arizona. With a strong foundation in nursing and nursing administration, she has dedicated more than three decades of service to Arizona and the nation. During her distinguished career in public service, she has demonstrated a dedication to upholding high standards for quality nursing and health care, and her service as executive director of the Arizona State Board of Nursing and as a national leader in nursing is exemplary. Joey’s nursing career began in the Maricopa Health System and expanded to her current position as executive director of the state Board of Nursing. Her appointment as president of the National Council of State Boards of Nursing for two consecutive terms reflects the high regard in which she is held throughout the United States. Joey presently serves as chair, Executive Committee, Nurse Licensure Compact Administrators. Among the most important of her work in Arizona are her memberships on Governor Napolitano’s Task Force on the Nursing Shortage, the Arizona Hospital and Healthcare Association’s Healthcare Institute, and the University of Arizona Health Sciences Center Greater Phoenix Leadership Board. Goal of Program 26 The goal of the Dream-Discover-Deliver Awards Program is to raise funds to support the College and its initiatives. This program currently funds student leadership travel to professional conferences, pilot studies, and provides financial support for student, alumni and faculty activities and initiatives. Innovations in Nursing & Health professional achievements awards/honors Five outstanding faculty were competitively selected to the American Academy of Nursing and were inducted in fall 2011. Joan Dodgson, PhD, MPH, RN; Colleen Keller, PhD, RN-C, FNP, FAHA, FNP; Denise Link, PhD, WHNP-BC, CNE, FNAP; Susan Stillwell, DNP, MSN, RN, CNE; and Elizabeth Reifsnider, PhD, RN, WHNP, PHCNS-BC, are the College’s new AAN Fellows. This esteemed honor is awarded to less than one percent of the nursing profession. They have been recognized for their extraordinary nursing careers and contributions that have had national impact in their areas of practice. From left: Colleen Keller, Joan Dodgson, Denise Link, Dean Teri Pipe, Elizabeth Reifsnider, Susan Stillwell. ASU Nutrition students achieved a 100 percent Registered Dietician (RD) exam pass rate in 2010 and a 100 percent pass rate for the Dietetic Technician Registered (DTR) exam. The national average pass rate for Didactic Programs in Dietetics (DPD) programs was 86 percent and 65 percent respectively for the RD and DTR exams. The National Collegiate Leadership Conference (NCLC) is held annually in Tucson, bringing together students from across the U.S. to take part in workshops, seminars, networking and service projects. At NCLC in 2011, ASU’s Student Nutrition Council won the Organization Achievement Award and was nominated and selected again as a finalist for the 2012 conference. Continuing the ASU tradition of excellence, junior dietetics student Rachel Cassinat was chosen as the 2012 recipient of the Excellence in Student Leadership Award. This award recognized her as "demonstrating exemplary leadership skills, a commitment to academic and civic pursuits, and a dedication to serving the community." The textbook, “Sleep Disorders and Sleep Promotion in Nursing Practice” has received the prestigious 2011 American Journal of Nursing Book of the Year Award. ASU College of Nursing and Health Innovation Associate Professor Carol Baldwin, PhD, RN, CHTP, CT, AHN-BC, FAAN, and Luxana Reynaga Ornelas, PhD, RN, University of Guanajuato School of Nursing and Obstetrics, Leon, Mexico, co-authored the chapter on Racial/Ethnic Health Disparities and Sleep. Angela Allen, RN, BSN, MAT, EdS, EA, CRRN, received the Nurse of the Year Award for Community Service presented by the National Black Nurses Association. The award recognizes outstanding and exemplary community service within the nursing profession, and was presented to Allen in July 2011 at the NBNA Institute of Excellence Ruby Award Ceremony in Indianapolis, Ind. Carol Baldwin, PhD, RN, CHTP, CT, AHN-BC, FAAN, was elected co-chair of the American Academy of Nursing (AAN) Global Nursing and Health Expert Panel, and co-chair of the 2012 AAN Conference pre-session planning committee co-sponsored by the Global Nursing and Health Expert Panel and the Emerging/Infectious Diseases Expert Panel. Baldwin also was elected to the exam writing committee of the International Certification in Thanatology exam and was given an Outstanding Service Award by the Association for Death Education and Counseling for her work as a board member. Evelyn Cesarotti, PhD, FNP-BC, FAANP, was competitively selected as a fellow in the American Academy of Nurse Practitioners in 2011 and Marianne McCarthy, PhD, RN, ANP, GNP, PMHNP, received the honor in 2012. Angela Chia-Chen Chen, PhD, RN, PMHNP-BC, was named visiting professor, Univ. of Calif. San Francisco Center for AIDS Prevention Studies. Bronwynne Evans, PhD, RN, FAAN, was an invited breakout session presenter and moderator at the National Institute of Nursing Research (NINR) Scientific Sum- mit "The Science of Compassion: Future Directions in End of Life and Palliative Care." The summit examined the many strides made in palliative care and was held in August 2011 in Bethesda, Md. In May 2011, Evans was an invited panelist at the “Health Care: Best Practices, Career Trends, and Call-to-Action Summit” presented by the U.S Department of Labor’s Office of Disability Employment Policy, in collaboration with Access Living in Chicago, Ill. Barbara Fargotstein, MN, RN, was competitively selected and appointed Lincoln Center for Applied Ethics Fellow in Nursing & Healthcare Ethics. Clinical Assistant Professor Ruth Flucker, MS, RN, RNMH, CNE, earned her PostMasters Certification as a child/family psychiatric nurse practitioner PMHNP. The Arizona Chapter of the March of Dimes presented its 2011 Nurse of the Year Award for Leadership to Associate Professor Bonnie Gance-Cleveland, PhD, RNC, PNP, FAAN. Gance-Cleveland also received NurseWeek’s Nursing Excellence Award–Mentoring for the Mountain West Region in 2011. Clinical Associate Professor Jack Gilbert, EdD, FACHE, director of the Master of Healthcare Innovation degree program, presented a seminar on “The Heart of Leadership” at the American College of Healthcare Executives 2012 Congress in Chicago, Ill. Clinical Professor Debra Hagler, PhD, RN, ACNS-BC, CNE, ANEF, was elected to the NLN Certification Commission that oversees and supervises the NLN Academic Nurse Educator Certification Program. Her term began in September 2011. Eric Hekler, PhD, completed a postdoctoral fellowship at Stanford University in 2011 and was appointed a tenure-track assistant professor in ASU’s School of Nutrition and Health Promotion. Hekler was honored by the Society of Behavioral Medicine with the Physical Activity Special Interest Group Student Award and the Meritorious Student Abstract Award for the Paper Session “Who Responds Better to a Computer-Delivered vs. Human-Delivered Physical Activity Intervention?”. Spring 2012 27 dream • discover • deliver Clinical Assistant Professor Gail Petersen Hock, RN, MS, PHCNSc, recently completed the Applied Health Informatics Program at Johns Hopkins University School of Nursing as an ONC Scholar. Hock was a member of the program’s inaugural cohort. The ONC (Office of the National Coordinator for Health Information Technology) is the principal federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. Also in 2011, Hock was appointed as a Gail Petersen Hock Quality Matters peer reviewer. Additionally, Hock received the Arizona Big Shot Award conferred by the Arizona Partnership for Immunization. An annual research award offered by the Physical Activity Special Primary Interest Group (PA SPIG) within the American Public Health Association (APHA) has been named after Steven Hooker, PhD, FACSM, of the School of Nutrition and Health Promotion. This honor recognized Hooker’s contribution as chair of the initial leadership team and the inaugural chair of the PA SPIG when it was formally recognized by APHA. Additionally, Hooker has accepted an invitation to become a board member of America Walks, the nation’s leading advocacy organization for pedestrian and walking issues at the national, state and local level. Debra Ilchak, DNP, RN, FNP-BC, CNE, won second place for her poster “Capturing Missed Opportunities for Chlamydia and Gonorrhea Screening” at The National Association of Nurse Practitioners in Women's Health 14th Annual Conference in Austin, Texas. Assistant Professor Diana Jacobson, PhD, RN, PNP-BC, earned her certification as a Pediatric Nurse Practitioner. Clinical Associate Professor Marcia Jasper, MS, RNC, received an award for her 31 years of service to the Arizona Chapter of the March of Dimes. Jasper has been an integral part of the March of Dimes Chapter Program Services Committee and has been a lead reviewer of the Chapter Community Grants Program, and will continue on the committee as an honorary member. 28 Denise Link, PhD, WHNP-BC, CNE, FNAP, FAAN, was elected to the board of directors of the Arizona Partnership Implementing Patient Safety (APIPS). APIPS is a statewide interdisciplinary association dedicated to promoting a safe health care environment for all patients in Arizona. Also in 2011, Link completed the UCLA/Johnson and Johnson Healthcare Executive program. Link also was selected as the Arizona recipient of the 2012 American Academy of Nursing State Award for Nurse Practitioner Excellence. Dr. Link was selected for recognition for her many years of evidencebased practice as a Women’s Health NP and for her service in nursing regulation and professional advocacy. Kathy Malloch, PhD, MBA, RN, FAAN, received the prestigious R. Louise McManus Award from the National Council of State Boards of Nursing (NCSBN) in August 2011. The award recognizes the efforts of individuals who have made significant contributions in nursing regulation through their dedication to the purposes and mission of the NCBSN. Barbara Miroballi, M.Ed., RN, graduated with distinction from Northern Arizona University in December, 2011 with a Master’s of Education, Educational Technology. Miroballi is a clinical instructor at the College of Nursing and Health Innovation. Adriana Perez, PhD, ANP, assistant professor and Southwest Borderlands Scholar, was selected as a 2011-2012 Health and Aging Policy Fellow. Supported by The Atlantic Philanthropies and directed by Harold Alan Pincus, MD, Professor of Psychiatry at Columbia University (in collaboration with the American Political Science Association Congressional Fellowship Program), the goal of the Health and Aging Policy Fellows Program is to create a cadre of professional leaders who will serve as positive change agents in health and aging policy, helping to shape a healthy and productive future for older Americans. Additionally, Dr. Perez, and Julie Fleury, PhD, FAAN, in partnership with the Phoenix Revitalization Corporation, are launching a "Moving Communities" program in Central City South, an urban downtown community in Phoenix, Ariz. The overarching goal is to build leadership, individual, and community capacity as a basis for reducing cardiovascular risk, and contributing to the development of sustainable community resources for physical activity and healthy diet. Innovations in Nursing & Health Associate Professor Kathie Records, PhD, RN, was appointed to the editorial advisory board of the Journal of Obstetric, Gynecologic and Neonatal Nursing, and also was appointed as reviewer, National Institutes of Health, Specialized Centers of Research (P50), Endocrinology, Metabolism, Nutrition and Reproductive Sciences IRG (EMNR). Professor Elizabeth Reifsnider, PhD, RN, WHNP, PHCNS-BC, FAAN, was named chair of the Public Health Nursing Awards Committee, Public Health Nursing Section, of the American Public Health Association for a term running from 2011-2013. Graduate student Angela Schroedl was competitively selected by the American Academy of Nurse Practitioners for a Mentee Fellowship. This fellowship will pair Schroedl with one of AANP’s Academy Fellows who specialized in diabetes and/ or minority health for one year to assist with her project development. Karen Sweazea, PhD, assistant professor in the School of Nutrition and Health Promotion, was nominated for the 2011 Outstanding Faculty Mentor Award by the ASU Faculty Women’s Association. Kimberly Vana, MS, RN, APRN, BC, NP-C, was appointed a clinical associate professor in the undergraduate nursing program. Vana completed the Doctorate of Nursing Practice at ASU in May 2011 and was awarded the ASU College of Nursing and Health Innovation’s Outstanding DNP Culminating Project. Research Assistant Professor Barbara Wilson, PhD, RNC, has been invited to speak at the American Nurses Credentialing Center (ANCC) Pathway to Excellence Conference (sponsored by the American Nurses Association) in Washington, D.C. in May. Wilson will discuss the outcome of a study she conducted at a local hospital examining the impact of horizontal hostility in the work environment and intent to leave, absenteeism, and patient safety. Christopher Wharton, PhD, assistant professor of nutrition, was awarded ASU’s President’s Award for Sustainability in 2011 for his project “Sustainability, Health, and Education through Local Foods: The PolyHarvest Community Supported Agriculture Program.” The PolyHarvest CSA is a community-supported agriculture program that delivers fresh, local produce to ASU and non-ASU community members and is operated on the downtown Phoenix campus. new grants Angela Chia-Chen Chen, PhD, RN, PMHNP-BC, is the principal investigator of “Developing Bilingual, Tailored Messages for HPV Vaccination Promotion Targeting Latino Parents/Guardians,” an Arizona State University College of Nursing and Health Innovation pilot grant. Chen is principal investigator for “Pilot Testing of a Web-based HIV/STI Prevention Intervention for Latina Adolescents,” a subcontract with the University of California San Francisco Center for AIDS Prevention Studies. Chen also was principal investigator of “Examining Feasibility and Acceptability of a Web-based HIV Prevention Survey among Asian Pacific Islanders and Latino College Students,” an ASU College of Nursing and Health Innovation small grant. Professor Bonnie Gance-Cleveland, PhD, RNC, PNP, FAAN, is principal investigator on “Connecting Members of Golden Gate Community Who Have or Are At-Risk for Hypertension and Diabetes to Services,” a grant funded by Catholic Healthcare in December 2011. Gance-Cleveland also is principal investigator for the study “Disseminating Best Practices for Obesity Care” that incorporates motivational interviewing and location detection to link community resources to mobile technology support for health care providers to address childhood obesity. Debra Hagler, PhD, RN, ACNS-BC, CNE, ANEF, is co-investigator for the study “Measuring Competency with Simulation, Phase 2,” National Council of State Boards of Nursing Center for Regulatory Excellence, September 2011- February 2013. Other ASU team members include Beatrice Kastenbaum, MSN, RN, CNE; Ruth Brooks, MS, RNC, BC; Eric Pennock, AAS; and Marlene Papish, RN, BSN, CNOR. Research Assistant Professor Stephanie Kelly, PhD, RN, FNP-BC, is co-investigator for a research grant from the American Organization of Nurse Executives. The purpose of “Ready to Lead? Transformational Leadership in Frontline Nurses” is to describe and analyze transformational leadership behaviors, current leadership training, and the relationship between leadership training and transformational leadership style in frontline nurse leaders in a large health system. Denise Link, PhD, WHNP-BC, CNE, FNAP, FAAN, received funding under the Title X Family Planning Program. The grant is the major source of funds for the NP Healthcare Grace clinic, a partnership between Grace Lutheran Church, the Arizona Family Health Partnership, and ASU. Link also spearheaded funding for the HIV Integration Project. The NP Healthcare Grace clinic is in its second, three-year cycle of funding under this program. Kinesiology Associate Professor Shannon D. Ringenbach, BPe, MSc, PhD, and doctoral student Chih-Chia Chen, are co-investigators on the study “The Effects of Music on Exercise: Motor, Cognitive and Affect Benefits in People with Down Syndrome,” funded by Special Olympics/CDC. Elizabeth Reifsnider, PhD, RN, WHNP, PHCNS-BC, FAAN, was awarded a contract by the Arizona Department of Health Services for “Evaluation of Baby Steps to Breastfeeding Success,” 2011-2012. Associate Research Professor and Associate Director of ASU’s Center for Health Innovation & Clinical Trials, Carl Yamashiro, PhD, Center Senior Coordinator Sharon Goldsworthy, MC, LPC, and Research Associate Professor Darya McClain, PhD, are co-investigators on the project “Examining the Effects of the TASER on Cognitive Functioning,” a three-year grant funded by the National Institute of Justice. Yamashiro also is project manager for a new NHGRI/NIH grant titled, “High Speed Sequencing by Chemical Recognition using Novel Nanopore Technology” with Bharath Takulapalli of ASU’s Biodesign Institute as principal investigator. appointments Christy Appel, PhD, RD and Lisa Morse, MS, RD, CNSC, have joined the faculty of the Nutrition program at the School of Nutrition and Health Promotion, both as lecturers. Appel is a Registered Dietitian and completed her BS, MS, and PhD at ASU in Nutrition. Morse completed her MS in Nutrition at ASU and has been the Head Registered Dietitian in the Burn Unit and Trauma Center at Maricopa Medical Center for more than 20 years. Angela Chia-Chen Chen, PhD, RD, PMHNP-BC, has been promoted to associate professor at the College of Nursing and Health Innovation. Cristi Coursen, PhD, WHNP, was appointed coordinator of the BS in Health Sciences Program for the School of Nutrition and Health Promotion. Coursen also is president-elect of the ASU Downtown Phoenix Campus Academic Assembly. Bronwynne Evans, PhD, RN, was promoted from associate professor to full professor at the ASU College of Nursing and Health Innovation. Jennifer Fay, MS, and Tannah Broman, MS, were appointed senior lecturers in the Kinesiology program and Kathryn Campbell, EdD, FACSM, was named senior lecturer in the Exercise and Wellness program at the School of Nutrition and Health Promotion. Theresa A. Floegel, MSN, RN, was recently appointed a clinical assistant professor. New to the state of Arizona and ASU, Floegel previously held a clinical faculty position in the College of Nursing at the University of Cincinnati in Cincinnati, Ohio, teaching concentrations in foundations, medical-surgical, and nursing leadership/management. Jennifer Marsteen has been appointed major gift officer for the College of Nursing and Health Innovation and the School of Nutrition and Health Promotion. In this role she is responsible for cultivating, soliciting and stewarding major gifts for the college and school. A graduate of California Lutheran University, Marsteen previously worked with the ASU Foundation as university development officer and the College of Liberal Arts and Sciences Jennifer Marsteen as development officer. Bradford Kirkman-Liff, BS, MBA, PhD, will be teaching health care management and policy in the MS of Public Health, as well as some individual classes in the MS, Clinical Research Management and MS Regulatory Science and Health Spring 2012 29 dream • discover • deliver Safety programs. He joined the College of Nursing and Health Innovation after the disestablishment of the School of Health Management and Policy at the Tempe campus in July 2010, where he had taught since 1980. Krista Oswalt, PhD, moved from a postdoctoral fellow position to a research assistant professor position at the College of Nursing and Health Innovation. Elizabeth Reifsnider, PhD, RN, WHNP, PHCNS-BC, FAAN, has been appointed to the Nancy Melvin Professor of Pediatric Nursing Endowed Chair at the ASU College of Nursing and Health Innovation. (See story on page 11.) Karen J. Saewert, PhD, RN, CPHQ, CNE, ANEF, was appointed senior director, Educational Support Services Health Solutions, Arizona State University. Dr. Saewert is a clinical associate professor at the ASU College of Nursing and Health Innovation. Carol Stevens, MS, RN, PhDc, has transitioned from program coordinator for the Nurses to Nurses (N2N) grant to clinical assistant professor in the RN-to-BSN program. Assistant Research Professor Barbara Wilson, PhD, RNC, was appointed as assistant director of the Center for Improv- ing Health Outcomes in Children, Teens, & Families at the ASU College of Nursing and Health Innovation. Wilson also was competitively selected as a member of the AWHONN 2012 Research Advisory Panel. Carl Yamashiro, PhD, has accepted a position at the College of Nursing and Health Innovation as associate research professor and associate director for the Center for Healthcare Innovation & Clinical Trials. Yamashiro has almost 20 years of research and development experience in the biotechnology and molecular diagnostics arenas and will be the program director for the Community Oriented Network for Enhanced Clinical Trials and Research. publications & presentations selected Ainsworth, B.E., & Macera, C.A. Physical Activity and Public Health Practice. 2012. Boca Raton, FL: CRC. Baldwin, C.M., McClain, D., Vital M., Chen, A.C.C., CaudilloCisneros C., et al. (2011, November). Daytime sleepiness and sleep symptoms of Mexican Americans and Mexicans: A bi-national comparative study. Paper presented at the Sigma Theta Tau International 22nd International Nursing Research Congress, Cancun, Mexico. Baldwin, C.M., & Reynaga-Ornelas, L. (2011). Cultural and Racial/Ethnic Aspects of Sleep. In N.S. Redeker and G.P. McEnany (Eds.), Sleep disorders and sleep promotion in nursing practice. New York: Springer. Bazzano, L.A., Tees, M.T., & Winham, D.M. (2011). Non-soy legume consumption lowers cholesterol levels: A meta-analysis of randomized controlled trials. Nutrition, Metabolism & Cardiovascular Diseases, 21, 94–103. Brown, M.A., Goodwin, J.L., Silva, G. E., Behari, A., Newman, A.B., Punjabi, N.M., et al. (2011). The impact of sleep-disordered breathing on body mass index (BMI): The Sleep Heart Health Study (SHHS). Southwest Journal of Pulmonary and Critical Care, 3, 159-168. Buman, M., Giacobbi Jr, P., Dzierzewski, J., Aiken, M.A., McCrae, C., Roberts, B., et al. (2011). Peer volunteers improve long-term maintenance of physical activity with older adults: A randomized controlled trial. 30 Journal of Physical Activity & Health, Recommendations for practitioners (CE article). Journal of the American 8, S257. Academy of Nurse Practitioners, Buman, M.P., Hekler, E.B., Bli23(5), 226-232. wise, D., & King, A.C. (2011). Exercise effects on night-to-night fluctua- Coon, D.W., Evans, B.C., Belyea, tions in self-rated sleep among older M., & Ume, E. (2011, November). adults with sleep complaints. Journal Latino family caregiving: Life course, life styles, and lifespan. Symposium of Sleep Research, 20, 28-37. conducted at the Gerontological Buman, M.P., Hekler, E.B., Society of America Annual ConferBliwise, D.L., & King, A.C. (2011). ence, Boston, MA. Moderators and mediators of exercise-induced objective sleep Davila, Y. R., Reifsnider, E., & improvements in midlife and older Pecina, I. (2011). Familismo: Influadults with sleep complaints. Health ence on Hispanic health behaviors. Applied Nursing Research, 24(4), Psychology, 30(5), 579-587. e67-e72. Chen, F., Hekler, E.B., Hu, J., Shen, L., & Zhao, C. (2011). Designing for Dodgson, J. E., Watkins, A., & context-sensitive self-monitoring, Choi, M. (2011). Evaluation of feedback, and engagement. Paper supportive breastfeeding hospital published and presented as part of practices: A community perspective. Advances in Nursing, 28(2), 17-30. the proceedings of annual meeting of the Association for Computing Drescher, A.A., Goodwin, J.L., Machinery’s Computer Supported Silva, G.E., & Quan, S.F. (2011). Cooperative Work Conference. Caffeine and screen time in adoHangzhou, China. http://portal.acm. lescence: Associations with short org/citation.cfm?id=1958927 sleep and obesity. Journal of Clinical Choi, M., & Chang, J. (2011). RN Sleep Medicine, 7(4), 337-342. to Advanced Practice Nursing in Evans, B.C. (2011, August). America [published in Korean]. Psychosocial, cultural, and spiritual Seoul, South Korea: Korea Medical aspects of end-of-life care. Invited Publishers. podium presenter and breakout Choi, M., & Hector, M. (2012). Efsession moderator, presented at fectiveness of intervention programs The Science of Compassion: Future in preventing falls: A systematic Directions in End of Life and Palliareview of recent 10 years and meta- tive Care Research, conducted by the National Institute for Nursing Reanalysis. JAMDA, 12(3), 188.e13search, National Institutes of Health, e188.e21. Bethesda, MD. Choi, M., & Yeom, H. (2011). Identifying and treating the culture-bound Evans, B.C., Belyea, M., & Ume, syndrome of Hwa-Byung among E. (2011). Mexican American males providing personal care for their older Korean immigrant women: Innovations in Nursing & Health mothers. Hispanic Journal of Behavioral Health, 33(2), 234- 260. Evans, B.C., Coon, D.W., & Ume, E. (2011). Use of theoretical frameworks as a pragmatic guide for mixed methods studies: A methodological necessity? Journal of Mixed Methods Research, 5(4), 276-292. Evans, B.C., & Smith, M. (2011, July). Opening doors for clinical students with disabilities: Building capacity for success. Invited presentation, Columbia University School of Nursing, New York, NY. Fokidis, H.B., Hurley, L., Rogowski, C., Sweazea, K., & Deviche, P. (2011). Effects of captivity and body condition on plasma corticosterone, locomotor behavior, and plasma metabolites in curve-billed thrashers. Physiological and Biochemical Zoology, 84(6), 595-606. Grant, M., McMullen, C., Altschuler, A., Mohler, J., Hornbrook, M.C., Herrinton, L., Wendel, C., Baldwin, C.M., & Krouse, R.S. (2011). Gender differences in quality of life among long-term colorectal cancer survivors with ostomies. Oncology Nursing Forum, 38(5), 587-596. Hagler, D. (2011). Managing your career. In P. Yoder-Wise (Ed.), Leading and managing in nursing (5th ed.)., Chapter 29. St. Louis: Mosby. Hagler, D. (2011). Foreword. In Visual nursing: A guide to diseases, skills, treatments (2nd ed). Philadelphia: Lippincott, Williams & Wilkins. Hagler, D., White, B., & Morris, B. (2011). Cognitive tools as a scaffold for faculty in curriculum redesign. Journal of Nursing Education, 49(7), 417-422. Hawthorne, A., Shaibi, G., GanceCleveland, B., & McFall, S. (2011). Grand Canyon Trekkers: Schoolbased lunchtime walking program. Journal of School Nursing, 27(1), 43-50. Hector, M., & Choi, M. (2011). Lessons learned from analyzing fall prevention programs. McKnight’s Long Term Care News & Assisted Living, November 18, from http:// www.mcknights.com/lessonslearned-from-analyzing-fall-prevention-programs/article/217162/ Hock, G. (2011, September). ONEshot Global—One shot saves two lives. Poster session presented at the fall meeting of the Arizona Public Health Association, Phoenix. Ilchak, D.L. (2011, June). Screen for chlamydia: It’s as easy as 1-2-pee. Podium presentation, American Academy of Nurse Practitioners 26th National Conference, Las Vegas. Jacobson, D.A. (2011, March). Primary Care Healthy Choices Intervention Program for overweight and obese school-age children and their parents. Paper presented at the National Association of Pediatric Nurse Practitioners 32nd Annual Conference on Pediatric Health Care: Charting the Course for Advocacy and Innovation, Baltimore, MD. Jacobson, D., & Melnyk, B.M. (2011). Psychosocial correlates of healthy beliefs, choices and behaviors in overweight and obese school-age children: A primary care Healthy Choices Intervention Pilot Study. Journal of Pediatric Nursing, 26, 456-464. Jacobson, D., Melnyk, B., Belyea, M., O’Haver, J., Kelly, S., Oswalt, K., & Hartmann, K. (2011, November). Key strategies to enhance and build effective research teams. Presentation at symposium entitled TEAM: Key Strategies for Forming and Sustaining Research Teams That Flourish, at the Sigma Theta Tau 41st Biennial Convention. Grapeville, TX. Kastenbaum, B., Hagler, D., Brooks, R., & Ruiz, E. (2011). Simulation: Realistic cultural encounters. Academic Exchange Quarterly, 15(2), 27-32. Kim, S., Kjervik, D., Belyea, M.J., & Choi, E. (2011). Personal strength and finding meaning in conjugally bereaved older adults: A four-year prospective analysis. Death Studies, 35(3), 197-218. Keller, C., Records, K., Ainsworth, B, Belyea, M.J., Permana, P., Coonrod, D., Vega-Lopez, S., & Nagle-Williams, A. (2011). Madres para la Salud: Design of a theory-based intervention for postpartum Latinas. Contemporary Clinical Trials, 32(3), 418-427. Kelly, L.A., McHugh, M.D., & Aiken, L.A. (2011). Nurse outcomes in Magnet® and non-Magnet hospitals. Journal of Nursing Administration, 41(10), 428-433. Kelly, S.A., Melnyk, B.M., Jacobson, D., & O’Haver, J. (2011). Correlates among healthy lifestyle cognitive beliefs, healthy lifestyle choices, social support, and healthy behaviors in adolescents: Implications for behavioral change strategies and future research. Journal of Pediatric Health Care, 25(4), 216-223. Lamb, G., Tappen, R., Diaz, S., Herndon, L. Ouslander, J. et al. (2011). Avoidability of hospital transfers of nursing home residents: Perspectives of frontline staff. Journal of the American Geriatrics Society, 59(9), 1665–1672. Lusk, P., & Melnyk, B.M. (2011). COPE for the treatment of depressed adolescents: Lessons learned from implementing an evidence-based practice change. Journal of the American Psychiatric Nurses Association, 17(4), 297-309. Lusk, P., & Melnyk, B.M. (2011). The brief cognitive-behavioral COPE intervention for depressed adolescents: Outcomes and feasibility of delivery in 30 minute outpatient visits. Journal of the American Psychiatric Nurses Association, 17(3), 226-236. Malloch, K. (2011, July). Personal leadership in a chaotic world: Strategies to save your sanity and increase your effectiveness. Preconference workshop presented at API Healthcare Client Forum, Milwaukee, WI. Malloch, K. (2011, August). Workforce optimization within the changing landscape of healthcare reform. Presentation at Healthcare Workforce Management Leadership Summit, Los Angeles, CA. Malloch, K. (2011, May). Nursing leadership for the future: Are you ready? Presentation at United Health and ASU College of Nursing and Health Innovation Invitational Health Innovation Lecture, Scottsdale, AZ. Malloch, K., & Porter-O’Grady, T. (2011). Innovations in academic and practice partnerships: New collaborations within existing models. Nursing Administration Quarterly. 35(1). Manant, A.L., & Dodgson, J.E. (2011). Centering pregnancy: An integrative review. Journal of Nurse Midwifery and Women’s Health, 56(2), 94-102. Marsiglia, F. F., Ayers, S., GanceCleveland, B., Mettler, K., & Booth, J. (2011). Beyond primary prevention of alcohol use: A culturally specific secondary prevention program for Mexican heritage adolescents. Prevention Science: The Official Journal of the Society for Prevention Research. doi:10.1007/s11121011-0263-0 Matyas, M.L., Lowy, M.E., Sweazea, K.L., & Alvarez, D.F. (2011). Monitoring physiology trainee needs to focus professional society responses: The APS Trainee Needs Surveys. Advances in Physiology Education. 35, 168177. McHugh, M.D., Kelly, L.A., Sloane, D.M., & Aiken, L.H. (2011). Contradicting fears, California’s nurse-topatient mandate did not reduce the skill level of the nursing workforce in hospitals. Health Affairs, 30(7), 1299-1306. Mendias, N., Davila, Y., Reifsnider, E., Douzar. B., Nelson, G., Teske, L. (2011). One-stop shopping for HIV information and resources: The HIV Case Manager Portal. JANAC (Journal of Nurses in AIDS Care). O’Haver, J., Szalacha, L., Jacobson, D., & Kelly, S. (2011). The relationships among body size, biological sex, ethnicity and healthy lifestyles in adolescents. Journal for Specialists in Pediatric Nursing, 16, 199-206. Payne L., Ainsworth, B.E., & Godby, J. (Eds.). (2010). Leisure, health, and wellness. College Park, PA: Venture. Rantz, M.J., Phillips, L., Aud, M., Marek, K.D., Hicks, L.L., Zaniletti, I., & Miller, S.J. (2011). Evaluation of aging in place model with home care services and registered nurse care coordination in senior housing. Nursing Outlook, 59(1), 37-46. Records, K. (2011). Prenatal depression. International Journal of Childbirth Education, 26(4), 19-22. Records, K., Keller, C., Ainsworth, B., & Permana, P. (2012). Instrument selection for randomized clinical trials: Why this and not that? Contemporary Clinical Trials, 33, 143-150. Records, K., Welborn, D., Casillas, R., & Coonrod, D. (2011, June). Mamas Saludables, Familias Saludables [Healthy Moms, Healthy Families]: Support group designed for Latinas with postpartum depression symptoms. Podium presentation at the Association of Women’s Health, Obstetric, and Neonatal Nursing: Inspire, Lead and Forge New Directions, Denver, CO. Records, K., & Wilson, B. (2011). Reflections on meeting women’s childbirth expectations. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 40(4), 394-398. Reed, P.G., & Shearer, N.B.C. (2011). Nursing knowledge and theory innovation. New York: Springer. Reed, P.G., & Shearer, N.B.C. (Eds.) (2012). Perspectives on nursing theory (5th ed.). Philadelphia: Lippincott Williams & Wilkins. Reifsnider, E. (2011) Breast feeding and contraception: Special considerations in obese women. In D. Conway (Ed.), Pregnancy in the obese woman (Ch. 11). Oxford: Wiley Blackwell. Reifsnider, E., & Croisant, S. (2011, November). Community engagement: An essential component of CTSA. American Public Health Association, 139th Annual Meeting, Washington, DC. Rhee, H., Belyea, M.J., Hunt, J.H., & Brasch, J. (2011). Effects of a peer-led asthma self-management program for adolescents. Archives of Pediatrics & Adolescent Medicine, 65(6), 513-519. Ringenbach, S.D.R., Chen, C.C., Riekena, A., & Mulvey, G.M. 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(2nd ed.). San in designing systems for patient on Nursing Informatics. Montreal, teristics in baccalaureate nursing Francisco, CA: Benjamin Cummings. safety. Podium presentation at 3rd students using guided classroom ex- Canada. Urbine, T., Link, D., Schneider, P., Annual Scholarship Forum, Center periences and reflective journaling. Smith, C.L., Toomey, M., Walker, Schmitz, E., and Kistler, K. (2012). for Improving Health Outcomes in Poster session, annual conference B.R., Braun, E.J., Wolf, B.O., McChildren, Teens and Families: Innoof the American Psychiatric Nurses Graw, K., & Sweazea, K.L. (2011). Nurse Practitioner and pharmacist collaboration in ambulatory care. vations to Address Health DispariAssociation, Anaheim, CA. Naturally high plasma glucose The Journal for Nurse Practitioners, ties. Phoenix, AZ. levels in mourning doves (Zenaida Saewert, K.J. (2011, October/ 8(3), 1-6. Wilson, B.L., & Butler, M. J. (2011). macroura) do not lead to high levels November). 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Human Movement Science, 30(4), 770-782. 32 Innovations in Nursing & Health new dimensions for ASU research nursingandhealth.asu.edu/research Nursing research at ASU has taken on new transdisciplinary and interprofessional dimensions in the past year with: • T32 NINR-funded Transdisciplinary Training in Health Disparities Science grant, • a partnership with the American Organization of Nursing Executives to establish the Transdisciplinary Consortium for Innovation Leadership in Health Care and Fellowship Program, • and a planning initiative funded by The Josiah Macy, Jr. Foundation to develop an integrated core curriculum to prepare primary care nurse practitioners, physicians and pharmacists to work closely together to serve the needs of rural and underserved areas. The College also collaborates closely with other health-related disciplines at ASU to promote good health, prevent and control disease, and improve health outcomes for patients and their families. The ASU College of Nursing and Health Innovation has made great strides in research with more than $25 million in research expenditures since 2008. It continues to build on that performance today. 500 N. 3rd Street, Phoenix, AZ 85004-0698 Y discover your potential explore lifelong learning FALL CLASS SCHEDULE Lactation Educator Course September 7 - October 5, 2012 3rd Annual State of the State: Symposium of Breastfeeding Research in Arizona September 28, 2012 Clinical Lactation Management October 12 - November 9, 2012 Ethical Wisdom: The Key to Leadership, Influence and Power October 19, 2012 MAGI’s Clinical Research Conference - West October - 24, 2012 with21the Academy for Continuing Education Comparative Effectiveness Research and U.S. Health Care Conference November 16 - 17, 2012 • expert faculty Basic •Life Support for Heatlhcare Providers (Initial and Renewal Courses) innovative programs Sessions available monthly • relevant content Online programsoriented available at healthsolutions.asu.edu/ace • outcomes • Email: continuing education credits ACE@asu.edu Phone: 602-496-7431 Web: healthsolutions.asu.edu/ace Academy for Continuing Education, Health Solutions, Arizona State University is an approved provider of continuing nursing education by the Arizona Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.